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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 24 of 24 Research Studies DisplayedShields AD, Battistelli J, Kavanagh L
Staying current: developing just-in-time evidence-ased learning objectives for a maternal cardiac arrest simulation curriculum.
The authors’ objective was to review the latest evidence on resuscitation care for maternal cardiac arrest (MCA) and to gain expert consensus on best practices to inform an evidence-based curriculum. A multidisciplinary panel of stakeholders in MCA developed an evidence-based simulation training, Obstetric Life Support™ (OBLS). The researchers found that a novel three-step process including reaffirmation of evidence process, systematic review, and a modified Research and Development technique resulted in unanimous consensus from experts in MCA resuscitation on existing and new just-in-time best practices to inform the learning objectives for an evidence-based curriculum.
AHRQ-funded; HS026169.
Citation: Shields AD, Battistelli J, Kavanagh L .
Staying current: developing just-in-time evidence-ased learning objectives for a maternal cardiac arrest simulation curriculum.
Cardiol Cardiovasc Med 2022 Jun;6(3):245-54. doi: 10.26502/fccm.92920260..
Keywords: Evidence-Based Practice, Education: Curriculum, Simulation, Heart Disease and Health, Cardiovascular Conditions, Women, Education: Academic
Gonzalez CM, Walker SA, Rodriguez N
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
This paper describes a skill-based elective designed to recognize and manage implicit bias for preclinical medical students. From 2017 to 2019, nine 1.5-hour sessions were delivered to 15 first-year medical students. A program evaluation based on focus groups with students and data from notes taken by the investigative team was conducted. Three themes were identified from the program evaluation: 1) Student engagement can be enhanced, 2) Instruction is empowering, and 3) Addressing bias in one’s own and witnessed encounters can be done.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Walker SA, Rodriguez N .
It can be done! A skills-based elective in implicit bias recognition and management for preclinical medical students.
Acad Med 2020 Dec;95(12S):S150-s55. doi: 10.1097/acm.0000000000003697..
Keywords: Education: Continuing Medical Education, Education: Academic
Brady AK, Brown W, Denson JL
Variation in intensive care unit intubation practices in pulmonary critical care medicine fellowship.
This study looked at outcomes of participation of fellows for Pulmonary and Critical Medicine (PCCM) training in endotracheal intubation in the medical intensive care unit (ICU). The authors administered a survey to a convenience sample of US PCCM fellows. A total of 89 discrete US PCCM and Internal Medicine CCM training programs were represented. Almost half (43%) of PCCM fellows were “always or almost always” designed the primary operator for intubation, whereas 21% of programs had the PCCM fellow “rarely or never” the primary operator responsible for intubating in the ICU. Various influencing factors included time of day, hospital policies, attending skill or preference, ICU census and acuity, and patient factors. There was an association between location of the training program but not program size whether the PCCM fellow was the primary operator.
AHRQ-funded; HS026122.
Citation: Brady AK, Brown W, Denson JL .
Variation in intensive care unit intubation practices in pulmonary critical care medicine fellowship.
ATS Sch 2020 Dec;1(4):395-405. doi: 10.34197/ats-scholar.2020-0004OC..
Keywords: Intensive Care Unit (ICU), Respiratory Conditions, Training, Education: Academic, Critical Care
Ajayi TB, Remein CD, Stafford RS
Cross-center virtual education fellowship program for early-career researchers in atrial fibrillation.
This paper discusses the results of the establishment of the atrial fibrillation (AF) Strategically Focused Research Network Cross-Center Fellowship Program to enhance the competencies of early-stage AF basic, clinical, and population health researchers through experiential education and mentorship. The effectiveness of the fellowship model was evaluated via mixed methods formative and summative surveys for the first 2 years. Productivity metrics were as high for the 12 fellows as they hoped with 50 AF-related manuscripts, 7 publications, 28 presentations, and 3 grant awards applications. The fellows reported medium to high satisfaction with the overall fellowship, webinar content and facilitation, staff communication and support, and program organization.
AHRQ-funded; HS026198.
Citation: Ajayi TB, Remein CD, Stafford RS .
Cross-center virtual education fellowship program for early-career researchers in atrial fibrillation.
Circ Arrhythm Electrophysiol 2020 Nov;13(11):e008552. doi: 10.1161/circep.120.008552..
Keywords: Heart Disease and Health, Cardiovascular Conditions, Education: Curriculum, Education: Academic
Bettencourt AP, Vance AJ, Jun J
Maximizing the academic nursing model in the era of COVID-19 and beyond.
This opinion paper revisits the 2016 American Association of Colleges of Nursing (AACN) position statement on academic nursing. In the age of COVID-19, the statement is reimagined as a means to maximize nursing’s contributions to this global health crises. The 2016 position statement discussed the potentials for nursing schools to work within healthcare systems beyond clinic training. Most academic nurses do not also provide clinical care which is limited by structural barriers that inhibit academic nursing transformation. Many academic nurses who also have a clinical practice have had to do so on their own time. This new vision would capitalize on nursing’s strength in population health. The authors urge nursing schools to transform their model of academic nursing.
AHRQ-funded; HS024552.
Citation: Bettencourt AP, Vance AJ, Jun J .
Maximizing the academic nursing model in the era of COVID-19 and beyond.
Nurs Outlook 2020 Sep-Oct;68(5):542-44. doi: 10.1016/j.outlook.2020.04.013..
Keywords: COVID-19, Nursing, Provider: Nurse, Public Health, Education: Academic
Kraut AS, Sheehy L, Schnapp BH
Effect of resident physicians in a supervisory role on efficiency in the emergency department.
The authors sought to examine the impact of a staffing model involving a supervisory resident "pre-attending" (PAT) on emergency department (ED) throughput and length of stay (LOS). Over 26,000 unique patient encounters at a university-affiliated community ED were retrospectively analyzed. They found that the presence of a PAT is associated with a statistically significant increase in service time of five minutes, but this magnitude is likely operationally insignificant. They concluded that the negligible increase in service time is offset by the benefit to residents' training.
AHRQ-funded; HS024558.
Citation: Kraut AS, Sheehy L, Schnapp BH .
Effect of resident physicians in a supervisory role on efficiency in the emergency department.
West J Emerg Med 2020 Aug 24;21(5):1266-69. doi: 10.5811/westjem.2020.7.46587..
Keywords: Emergency Department, Education: Academic, Training
Toledo P, Lewis CR, Lange EMS
Women and underrepresented minorities in academic anesthesiology.
The demographics of the United States is changing with 51% of the population being female, and 32% of the population identifying as an underrepresented minority (URM, ie, African American/black, Hispanic/Latino, American Indian/Alaska Native, Native Hawaiian/Pacific Islander). This article provides an overview of the current status of women and URM faculty in academic anesthesiology and provides a framework for academic advancement.
AHRQ-funded; HS025267; HS026169.
Citation: Toledo P, Lewis CR, Lange EMS .
Women and underrepresented minorities in academic anesthesiology.
Anesthesiol Clin 2020 Jun;38(2):449-57. doi: 10.1016/j.anclin.2020.01.004..
Keywords: Provider: Physician, Provider, Workforce, Women, Racial and Ethnic Minorities, Education: Academic
Massarweh NN, LeMaire SA, Merkow RP
Preserving an academic mission in the face of clinical productivity targets: where is the academic surgeon's carrot?
This article discusses the emphasis on financial productivity at academic institutions and how it does and will impact the educational and research missions of academic departments and their faculty. Discussions include potential consequences and potential solutions, concluding that academic surgery departments, hospitals, and health systems should work collaboratively toward the common goal of supporting a unified mission of innovation, creativity, and clinical excellence.
AHRQ-funded; HS023011.
Citation: Massarweh NN, LeMaire SA, Merkow RP .
Preserving an academic mission in the face of clinical productivity targets: where is the academic surgeon's carrot?
Ann Surg 2020 Feb;271(2):223-24. doi: 10.1097/sla.0000000000003380..
Keywords: Education: Academic, Health Services Research (HSR)
McDaniel CE, Rooholamini SN, Desai AD
A qualitative evaluation of a clinical faculty mentorship program using a realist evaluation approach.
The objectives of this study were to test and refine a program theory for an institutional mentorship program for junior clinically-focused faculty and to understand the facilitators and barriers of sustained participation. The authors identified 4 contextual themes, 3 mechanisms, and 3 outcomes, which they organized into a programmatic theory representing the program's impact on participants. They found that a mentorship program that provided junior faculty with opportunities to connect, share ideas and strategies, and self-reflect led to improvement in meaningful outcomes for clinically focused faculty. They concluded that their program theory provided a basis for institutions seeking to build a mentorship program targeted towards this increasing proportion of junior faculty.
AHRQ-funded; HS024299.
Citation: McDaniel CE, Rooholamini SN, Desai AD .
A qualitative evaluation of a clinical faculty mentorship program using a realist evaluation approach.
Acad Pediatr 2020 Jan-Feb;20(1):104-12. doi: 10.1016/j.acap.2019.08.008..
Keywords: Education: Continuing Medical Education, Education: Academic
Hande K, Christenbery T, Phillippi J
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
The purpose of this pilot study was to determine the feasibility of a doctor of nursing practice (DNP) appreciative advising model to advise students through the rigors of DNP education and improve student and faculty satisfaction. Faculty were provided with comprehensive guidebooks and received orientation on the model; qualitative responses were analyzed using content analysis. Results showed that the student and faculty participants reported satisfaction with the model and commented that the model allowed for early identification of needs and was helpful and worthwhile. These results suggest that the model may hold promise as a solution to assist students in adjusting to DNP education.
AHRQ-funded; HS024733.
Citation: Hande K, Christenbery T, Phillippi J .
Appreciative advising pilot study: an innovative approach to advising doctor of nursing practice students.
Nurse Educ 2019 Jul/Aug;44(4):187-91. doi: 10.1097/nne.0000000000000593..
Keywords: Provider: Nurse, Nursing, Education: Academic, Education: Continuing Medical Education
Gonzalez CM, Deno ML, Kintzer E
A qualitative study of New York medical student views on implicit bias instruction: implications for curriculum development.
The purpose of this study was to explore student perceptions of challenges and opportunities when participating in implicit bias instruction. The authors indicated that their analysis suggested a range of attitudes toward implicit bias instruction and identified contextual factors that may have influenced these attitudes. The themes were (1) resistance; (2) shame; (3) the negative role of the hidden curriculum; and (4) structural barriers to student engagement.
AHRQ-funded; HS023199.
Citation: Gonzalez CM, Deno ML, Kintzer E .
A qualitative study of New York medical student views on implicit bias instruction: implications for curriculum development.
J Gen Intern Med 2019 May;34(5):692-98. doi: 10.1007/s11606-019-04891-1..
Keywords: Education: Curriculum, Education: Continuing Medical Education, Education: Academic
Chopra V, Harrod M, Winter S
Focused ethnography of diagnosis in academic medical centers.
J Hosp Med 2018 Oct;13(10):668-72. doi: 10.12788/jhm.2966.
This ethnographic study focused on the progress of teaching diagnosis to trainees in academic teaching hospitals. Trainees at 2 academic medical centers were observed to understand the barriers and facilitators to diagnosis. A total of 4 teaching teams between January and May 2016 were observed. Four key themes were identified and can be used to inform future interventions.
This ethnographic study focused on the progress of teaching diagnosis to trainees in academic teaching hospitals. Trainees at 2 academic medical centers were observed to understand the barriers and facilitators to diagnosis. A total of 4 teaching teams between January and May 2016 were observed. Four key themes were identified and can be used to inform future interventions.
AHRQ-funded; HS024385; HS022835.
Citation: Chopra V, Harrod M, Winter S .
Focused ethnography of diagnosis in academic medical centers.
J Hosp Med 2018 Oct;13(10):668-72. doi: 10.12788/jhm.2966..
Keywords: Education: Continuing Medical Education, Education: Academic, Diagnostic Safety and Quality, Cultural Competence
Burgess JF, Menachemi N, Maciejewski ML
Update on the health services research doctoral core competencies.
The purpose of this study was to present revised core competencies for doctoral programs in health services research (HSR), modalities to deliver these competencies, and suggested methods for assessing mastery of these competencies. The study concluded that core competencies in HSR are a continually evolving work in progress because new research questions arise, new methods are developed, and the trans-disciplinary nature of the field leads to new multidisciplinary and team building needs.
AHRQ-funded.
Citation: Burgess JF, Menachemi N, Maciejewski ML .
Update on the health services research doctoral core competencies.
Health Serv Res 2018 Oct;53(Suppl 2):3985-4003. doi: 10.1111/1475-6773.12851..
Keywords: Education: Academic, Education: Continuing Medical Education, Health Services Research (HSR), Training
Frogner BK
Update on the stock and supply of health services researchers in the United States.
This study examines the stock and supply including educational pipeline of health services researchers (HSRers) in the United States. The study found that the average annual growth rate of HSRers appeared to be within range of national recommendations. The authors asserted that additional work is needed to assess whether supply of HSRers is meeting demand and to ensure a competent and diverse educational pipeline that meets the needs of an evolving health system.
AHRQ-funded; 233201600155.
Citation: Frogner BK .
Update on the stock and supply of health services researchers in the United States.
Health Serv Res 2018 Oct;53(Suppl 2):3945-66. doi: 10.1111/1475-6773.12988..
Keywords: Education: Academic, Health Services Research (HSR), Research Methodologies
Calabrese SK, Earnshaw VA, Krakower DS
A closer look at racism and heterosexism in medical students' clinical decision-making related to HIV pre-exposure prophylaxis (PrEP): implications for PrEP education.
In this survey study of 115 US medical students, researchers examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. They concluded that prior PrEP education did not buffer any indirect effects. Also, heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.
AHRQ-funded; HS022986.
Citation: Calabrese SK, Earnshaw VA, Krakower DS .
A closer look at racism and heterosexism in medical students' clinical decision-making related to HIV pre-exposure prophylaxis (PrEP): implications for PrEP education.
AIDS Behav 2018 Apr;22(4):1122-38. doi: 10.1007/s10461-017-1979-z.
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Keywords: Decision Making, Education: Academic, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities
Kaplan RM, Fang Z, Kirby J
Educational attainment and health outcomes: data from the Medical Expenditures Panel Survey.
This study explored the extent to which health care utilization and health risk-taking can explain the education-health gradient above and beyond what can be explained by previously examined mediators such as age, race, and poverty status. It found systematic graded relationships between educational attainment and health including, SF-12 PCS scores, self-rated health, and activity limitations. Education was associated with more office visits and outpatient visits and less risk tolerance.
AHRQ-authored.
Citation: Kaplan RM, Fang Z, Kirby J .
Educational attainment and health outcomes: data from the Medical Expenditures Panel Survey.
Health Psychol 2017 Jun;36(6):598-608. doi: 10.1037/hea0000431.
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Keywords: Education: Academic, Education, Health Status, Medical Expenditure Panel Survey (MEPS)
Roy B, Gottlieb AS
The career advising program: a strategy to achieve gender equity in academic medicine.
This paper discusses the significant gender disparities in academic rank which exist at US medical schools, even after controlling for age, time since training, specialty, and measures of productivity, and despite increasing numbers of women entering medicine over the past 30 years. They highlight the Society of General Internal Medicine’s Women and Medicine Task Force and the model they launched in 2013 to address these disparities- the Career Advising Program (CAP).
AHRQ-funded; HS023000.
Citation: Roy B, Gottlieb AS .
The career advising program: a strategy to achieve gender equity in academic medicine.
J Gen Intern Med 2017 Jun;32(6):601-02. doi: 10.1007/s11606-016-3969-7..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist
Wasson LT, Cusmano A, Meli L
Association between learning environment interventions and medical student well-being: a systematic review.
This review sought to identify best practices for undergraduate medical education learning environment interventions that are associated with improved emotional well-being of students. Limited evidence suggested that some specific learning environment interventions were associated with improved emotional well-being among medical students. However, the overall quality of the evidence was low, highlighting the need for high-quality medical education research.
AHRQ-funded; HS024598.
Citation: Wasson LT, Cusmano A, Meli L .
Association between learning environment interventions and medical student well-being: a systematic review.
JAMA 2016 Dec 6;316(21):2237-52. doi: 10.1001/jama.2016.17573.
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Keywords: Education: Academic, Evidence-Based Practice, Behavioral Health
Gibbs EL, Kass AE, Eichen DM
Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders.
The researchers examined the misuse of attention-deficit/hyperactivity disorder (ADHD)-specific stimulants in a college population at high risk for or with clinical or subclinical eating disorders. They found that ADHD-specific stimulant misuse is associated with eating disorder and comorbid pathology among such individuals, recommending that screening for stimulant misuse and eating disorder pathology may improve identification of college-age women who may be engaging in maladaptive behaviors and inform prevention efforts.
AHRQ-funded; HS000078.
Citation: Gibbs EL, Kass AE, Eichen DM .
Attention-deficit/hyperactivity disorder-specific stimulant misuse, mood, anxiety, and stress in college-age women at high risk for or with eating disorders.
J Am Coll Health 2016 May-Jun;64(4):300-8. doi: 10.1080/07448481.2016.1138477.
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Keywords: Education: Academic, Behavioral Health, Medication, Substance Abuse, Young Adults
Sulzer SH, Feinstein NW, Wendland CL
Assessing empathy development in medical education: a systematic review.
The authors examined how researchers define the central construct of empathy and what they choose to measure. They found that the majority of studies were characterised by internal inconsistencies and vagueness in both the conceptualization and operationalization of empathy, constraining the validity and usefulness of the research. They suggested that future research follow the lead of basic scientific research that conceptualizes empathy as relational rather than as a personal quality that may be modified wholesale through appropriate training.
AHRQ-funded; HS000032.
Citation: Sulzer SH, Feinstein NW, Wendland CL .
Assessing empathy development in medical education: a systematic review.
Med Educ 2016 Mar;50(3):300-10. doi: 10.1111/medu.12806.
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Keywords: Education: Academic, Education: Continuing Medical Education, Patient-Centered Healthcare, Clinician-Patient Communication
Earnshaw VA, Jin H, Wickersham JA
Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?
This study sought to inform interventions to reduce stigma toward men who have sex with men (MSM) living in countries with strong stigma toward MSM, particularly among healthcare providers. It found that multivariate analyses of variance suggest that medical and dental students who had interpersonal contact with MSM were less prejudiced toward and had lower intentions to discriminate against MSM.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Jin H, Wickersham JA .
Stigma toward men who have sex with men among future healthcare providers in Malaysia: would more interpersonal contact reduce prejudice?
AIDS Behav 2016 Jan;20(1):98-106. doi: 10.1007/s10461-015-1168-x.
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Keywords: Education: Academic, Human Immunodeficiency Virus (HIV), Provider, Clinician-Patient Communication, Social Stigma
Forehand RL, Williamson RS, Russo GS
College health as a partner in the care of pediatric cancer survivors.
The authors reviewed an initiative to educate providers on pediatric cancer survivor care and to establish a cancer survivor registry in a college health center. They concluded that, through education and optimization of health informatics, college health centers can identify and provide survivor care to this medically vulnerable population.
AHRQ-funded; HS021251.
Citation: Forehand RL, Williamson RS, Russo GS .
College health as a partner in the care of pediatric cancer survivors.
J Am Coll Health 2014;62(7):506-10. doi: 10.1080/07448481.2014.917655.
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Keywords: Cancer, Health Services Research (HSR), Young Adults, Education: Academic
Ness GL, Sheehan AH, Snyder ME
Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.
The researchers conducted a cross-sectional survey of 212 graduating student pharmacists to characterize their views of professionalism on popular social media sites. The themes identified in the analysis were separation of personal and professional lives, how accountability for actions should vary by severity, and the extent of representation of the students’ character on social media.
AHRQ-funded; HS022119.
Citation: Ness GL, Sheehan AH, Snyder ME .
Graduating student pharmacists' perspectives on e-professionalism and social media: qualitative findings.
J Am Pharm Assoc 2014 Mar-Apr;54(2):138-43. doi: 10.1331/JAPhA.2014.13188..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist, Social Media
Pershing S, Fuchs VR
Restructuring medical education to meet current and future health care needs.
The authors ask whether the duration, sequencing, and requirements of medical education are appropriate to meet current and future challenges to medical care. They conclude that a much more agile system that prepares physicians to practice in a changing environment is needed. This will require change at both the macro regulatory level (e.g., accreditation bodies and specialty boards) as well as the micro level of individual programs taking initiative in innovation.
AHRQ-funded; HS000028.
Citation: Pershing S, Fuchs VR .
Restructuring medical education to meet current and future health care needs.
Acad Med 2013 Dec;88(12):1798-801. doi: 10.1097/acm.0000000000000020..
Keywords: Education: Academic, Education: Continuing Medical Education, Education: Curriculum
