National Healthcare Quality and Disparities Report
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- Access to Care (1)
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- Provider Performance (4)
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- Simulation (5)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 52 Research Studies DisplayedRubio DM, Mayowski CA, Norman MK
A multi-pronged approach to diversifying the workforce.
This paper describes a multi-pronged, collaborative approach to enhance the diversity of trainees and scholars at the University of Pittsburgh Institute for Clinical Research Education. It describes the Career Education and Enhancement for Health Care Research Diversity (CEED) program, designed for postdoctoral fellows and junior faculty and the CEED II program designed for medical students.
AHRQ-funded; HS023185.
Citation: Rubio DM, Mayowski CA, Norman MK .
A multi-pronged approach to diversifying the workforce.
Int J Environ Res Public Health 2018 Oct 11;15(10). doi: 10.3390/ijerph15102219..
Keywords: Education: Continuing Medical Education, Research Methodologies, Training
Murray DJ, Boyle WA, Beyatte MB
Decision-making skills improve with critical care training: using simulation to measure progress.
Health care professionals are expected to acquire decision-making skills during their training, but few methods are available to assess progress in acquiring these essential skills. The purpose of this study was to determine whether a simulation methodology could be used to assess whether decision-making skills improve during critical care training. The investigators indicate that their findings provide evidence to support the validity of a simulation-based method to assess progress in decision-making skills.
AHRQ-funded; HS022265.
Citation: Murray DJ, Boyle WA, Beyatte MB .
Decision-making skills improve with critical care training: using simulation to measure progress.
J Crit Care 2018 Oct;47:133-38. doi: 10.1016/j.jcrc.2018.06.021..
Keywords: Critical Care, Education: Continuing Medical Education, Decision Making, Simulation, Teams, Training
Gilmartin H, Saint S, Rogers M
Pilot randomised controlled trial to improve hand hygiene through mindful moments.
The purpose of this study was to evaluate the effectiveness of a brief mindfulness intervention on hand hygiene performance and mindful attention for inpatient physician teams. The investigators found that the intervention improved hand hygiene in attending physicians and residents, but not in medical students. The intervention was well-received, increased mindfulness practice, and appeared to be a feasible way to introduce mindfulness in the clinical setting.
AHRQ-funded; HS024385.
Citation: Gilmartin H, Saint S, Rogers M .
Pilot randomised controlled trial to improve hand hygiene through mindful moments.
BMJ Qual Saf 2018 Oct;27(10):799-806. doi: 10.1136/bmjqs-2017-007359..
Keywords: Education: Continuing Medical Education, Inpatient Care, Patient Safety, Prevention, Training
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
Winkler SL, Kairalla JA, Cooper R
Comparison of functional benefits of self-management training for amputees under virtual world and e-learning conditions.
This project used a randomized design to compare two methods of disseminating an evidence-based self-management intervention for amputees, which included, avatar-based virtual world and e-learning environments. The investigators found that the virtual world group had a significantly higher dropout rate than the e-learning group.
AHRQ-funded; HS022021.
Citation: Winkler SL, Kairalla JA, Cooper R .
Comparison of functional benefits of self-management training for amputees under virtual world and e-learning conditions.
Journal of Alternative Medicine Research 2018;10(1):65-72..
Keywords: Communication, Education: Patient and Caregiver, Evidence-Based Practice, Health Information Technology (HIT), Patient Self-Management, Training
Lewis Gilbert A, McCord AL, Ouyang F
Characteristics associated with confidential consultation for adolescents in primary care.
This study examines how provider report of confidential consultation in the electronic health record is associated with adolescent characteristics, health risk factors, and provider training. The study found that provider training is needed to reinforce the importance of confidential consultation for all adolescents.
AHRQ-funded; HS022681.
Citation: Lewis Gilbert A, McCord AL, Ouyang F .
Characteristics associated with confidential consultation for adolescents in primary care.
J Pediatr 2018 Aug;199:79-84.e1. doi: 10.1016/j.jpeds.2018.02.044..
Keywords: Children/Adolescents, Education: Continuing Medical Education, Electronic Health Records (EHRs), Primary Care, Training
Forrest CB, Chesley FD, Tregear ML
AHRQ Author: Chesley FD, Mistry KB
Development of the learning health system researcher core competencies.
The purpose of this study was to develop core competencies for learning health system (LHS) researchers to guide the development of training programs. The investigators found that the iterative development process yielded seven competency domains: (1) systems science; (2) research questions and standards of scientific evidence; (3) research methods; (4) informatics; (5) ethics of research and implementation in health systems; (6) improvement and implementation science; and (7) engagement, leadership, and research management.
AHRQ-authored; AHRQ-funded; 290201200017I.
Citation: Forrest CB, Chesley FD, Tregear ML .
Development of the learning health system researcher core competencies.
Health Serv Res 2018 Aug;53(4):2615-32. doi: 10.1111/1475-6773.12751..
Keywords: Education: Continuing Medical Education, Learning Health Systems, Training
Adrian M, Lyon AR, Nicodimos S
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
This study examined the impact of a 6-hr continuing education training, and the effect of a post-training reminder system, on mental health practitioners' knowledge, attitudes, and behavior surrounding suicide assessment and intervention. All practitioners, involved in the study, demonstrated increase in suicide assessment knowledge and attitudes for engaging in suicide risk assessments from pre- to posttest, and gains were maintained at the 3-month follow-up. The use of e-mail reminders was not associated with any additional changes.
AHRQ-funded; HS022982.
Citation: Adrian M, Lyon AR, Nicodimos S .
Enhanced "train and hope" for scalable, cost-effective professional development in youth suicide prevention.
Crisis 2018 Jul;39(4):235-46. doi: 10.1027/0227-5910/a000489..
Keywords: Education: Continuing Medical Education, Behavioral Health, Patient-Centered Healthcare, Prevention, Training
Bateni SB, Canter RJ, Meyers FJ
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgical decision-making in patients with advanced cancer requires careful thought and deliberation to balance the high risks with the potential palliative benefits. In this study, the investigators sought to compare surgical decision-making and palliative care training among surgeons and medical physicians who commonly treat advanced cancer patients. The investigators concluded that substantial deficiencies in palliative care training persised among surgeons and were associated with more aggressive recommendations for treatment for the selected scenarios presented in patients with advanced cancer.
AHRQ-funded; HS022236.
Citation: Bateni SB, Canter RJ, Meyers FJ .
Palliative care training and decision-making for patients with advanced cancer: a comparison of surgeons and medical physicians.
Surgery 2018 Jul;164(1):77-85. doi: 10.1016/j.surg.2018.01.021..
Keywords: Decision Making, Palliative Care, Cancer, Surgery, Education: Continuing Medical Education, Training
Shoemaker SJ, Brach C, Edwards A
AHRQ Author: Brach C
Opportunities to improve informed consent with AHRQ training modules.
Patients often do not understand the risks, benefits, and alternatives of undergoing specific interventions, even after signing a consent form. This paper describes a mixed-methods pilot test of two Agency for Healthcare Research and Quality (AHRQ) informed consent training modules that was implemented in four hospitals. The study concluded that many opportunities exist for hospitals to improve their informed consent practices.
AHRQ-authored; AHRQ-funded; 290201000031I.
Citation: Shoemaker SJ, Brach C, Edwards A .
Opportunities to improve informed consent with AHRQ training modules.
Jt Comm J Qual Patient Saf 2018 Jun;44(6):343-52. doi: 10.1016/j.jcjq.2017.11.010..
Keywords: Decision Making, Education: Continuing Medical Education, Health Literacy, Hospitals, Clinician-Patient Communication, Training
Boyle WA, Murray DJ, Beyatte MB
Simulation-based assessment of critical care "front-line" providers.
The researchers developed a standardized simulation method to assess clinical skills of ICU providers. Their simulation assessments yielded reasonably reliable measures of Critical Care Medicine decision-making skills. Despite a wide range of performance, those with more ICU training and experience performed better, providing evidence to support the validity of the scores.
AHRQ-funded; HS018734; HS022265.
Citation: Boyle WA, Murray DJ, Beyatte MB .
Simulation-based assessment of critical care "front-line" providers.
Crit Care Med 2018 Jun;46(6):e516-e22. doi: 10.1097/ccm.0000000000003073.
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Keywords: Critical Care, Decision Making, Intensive Care Unit (ICU), Provider Performance, Training
Barsuk JH, Cohen ER, Williams MV
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Physicians-in-training often perform bedside thoracenteses in academic medical centers, and complications are more common among less experienced clinicians. Simulation-based mastery learning (SBML) is one potential solution to this problem. This study evaluated the effects of a randomized trial of thoracentesis SBML on patient complications: iatrogenic pneumothorax, hemothorax, and reexpansion pulmonary edema.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
Simulation-based mastery learning for thoracentesis skills improves patient outcomes: a randomized trial.
Acad Med 2018 May;93(5):729-35. doi: 10.1097/acm.0000000000001965..
Keywords: Education: Continuing Medical Education, Patient Safety, Provider, Provider: Physician, Simulation, Training
Henriksen K, Rodrick D, Grace EN
AHRQ Author: Henriksen K, Rodrick D, Grace EN, Brady PJ
Challenges in health care simulation: are we learning anything new?
Simulation training is considered a promising approach for improving the safety and quality of health services delivery. While it takes time for any new approach to gain momentum and learn from past efforts, it also will require addressing a systematic range of essential questions to improve existing knowledge on the optimal use of simulation, and to realize similar gains in safety that other high-risk industries have made.
AHRQ-authored.
Citation: Henriksen K, Rodrick D, Grace EN .
Challenges in health care simulation: are we learning anything new?
Acad Med 2018 May;93(5):705-08. doi: 10.1097/acm.0000000000001891.
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Keywords: Healthcare Delivery, Quality of Care, Patient Safety, Training
Mazur LM, Marks LB, McLeod R
Promoting safety mindfulness: recommendations for the design and use of simulation-based training in radiation therapy.
The authors of this paper propose principles for the effective design and use of simulated scenarios, and describe a conceptual framework for a debriefing approach, to foster successful training that is focused on safety mindfulness during radiation therapy professionals' interactions with health information technology.
AHRQ-funded; HS023458.
Citation: Mazur LM, Marks LB, McLeod R .
Promoting safety mindfulness: recommendations for the design and use of simulation-based training in radiation therapy.
Adv Radiat Oncol 2018 Apr-Jun;3(2):197-204. doi: 10.1016/j.adro.2018.01.002..
Keywords: Health Information Technology (HIT), Patient Safety, Training
Mohan V, Scholl G, Gold JA
Use of EHR-based simulation to diagnose aetiology of information gathering issues in struggling learners: a proof of concept study.
The researchers previously documented that high-fidelity EHR-based simulation improves EHR usability and, when combined with eye and screen tracking, generates important measures of usability. They hypothesised that the same simulation exercise could help distinguish whether learners had difficulty in knowledge, information gathering or information processing. In this paper, they report the results of the first three struggling learners who participated in this exercise.
AHRQ-funded; HS023793; HS021637.
Citation: Mohan V, Scholl G, Gold JA .
Use of EHR-based simulation to diagnose aetiology of information gathering issues in struggling learners: a proof of concept study.
BMJ Simul Technol Enhanc Learn 2018 Apr;4(2):92-94. doi: 10.1136/bmjstel-2017-000217.
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Keywords: Diagnostic Safety and Quality, Electronic Health Records (EHRs), Health Services Research (HSR), Training
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI .
Strategies to improve management of shoulder dystocia under the AHRQ Safety Program for Perinatal Care.
J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Stefanidis D
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
The purpose of this study was to validate a novel Intracorporeal Suturing Assessment Tool (ISAT) by comparing it with existing measures that have been reported to have validity evidence. The study found that the ISAT accurately assessed laparoscopic suturing skill related to other instruments. Unlike the generic Global Operative Assessment of Laparoscopic Skills (GOALS), ISAT includes specific information that can provide feedback on trainee suturing ability and targeted performance improvements.
AHRQ-funded; HS022080.
Citation: Stefanidis D .
Developing a robust suturing assessment: validity evidence for the intracorporeal suturing assessment tool.
Surgery 2018 Mar;163(3):560-64. doi: 10.1016/j.surg.2017.10.029..
Keywords: Education: Continuing Medical Education, Tools & Toolkits, Training
Taylor LK, Thomas GW, Karam MD
Developing an objective assessment of surgical performance from operating room video and surgical imagery.
IISE Trans Healthc Syst Eng 2018;88(2):110-16. doi: 10.1080/24725579.2017.1418767.
An unbiased, repeatable process for assessing operating room performance is an important step toward quantifying the relationship between surgical training and performance. This study analyzed the following performance measures: duration of wire navigation, number of fluoroscopic images collected, degree of intervention by the surgeon's supervisor, and the tip-apex distance (TAD). The study results indicated that two metrics of hip fracture wire navigation performance, duration and TAD, significantly differentiated surgical experience.
An unbiased, repeatable process for assessing operating room performance is an important step toward quantifying the relationship between surgical training and performance. This study analyzed the following performance measures: duration of wire navigation, number of fluoroscopic images collected, degree of intervention by the surgeon's supervisor, and the tip-apex distance (TAD). The study results indicated that two metrics of hip fracture wire navigation performance, duration and TAD, significantly differentiated surgical experience.
AHRQ-funded; HS022077.
Citation: Taylor LK, Thomas GW, Karam MD .
Developing an objective assessment of surgical performance from operating room video and surgical imagery.
IISE Trans Healthc Syst Eng 2018;88(2):110-16. doi: 10.1080/24725579.2017.1418767..
Keywords: Provider Performance, Surgery, Training, Education: Continuing Medical Education
Geis GL, Wheeler DS, Bunger A
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
The aim of this study was to create a validity argument for the use of a simulation-based training course centered on assessment, recognition, and early management of sepsis in a laboratory-based setting. The authors concluded that, although incomplete, evidence from initial testing suggests that the simulations of pediatric sepsis were sufficiently valid to justify their use in training novice pediatric physicians in the assessment, recognition, and management of pediatric sepsis.
AHRQ-funded; HS020455.
Citation: Geis GL, Wheeler DS, Bunger A .
A validation argument for a simulation-based training course centered on assessment, recognition, and early management of pediatric sepsis.
Simul Healthc 2018 Feb;13(1):16-26. doi: 10.1097/sih.0000000000000271..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Sepsis, Training
Myers CG, Kudsi OY, Ghaferi AA
Social media as a platform for surgical learning: use and engagement patterns among robotic surgeons.
This study analyzed data from a closed-membership Facebook group for robotic surgeons to better understand surgeons' engagement with social media platforms. This analysis observed that surgeons responded to text posts with more comments, but "liked" posts containing links, photos, or video images in greater numbers.
AHRQ-funded; HS023621.
Citation: Myers CG, Kudsi OY, Ghaferi AA .
Social media as a platform for surgical learning: use and engagement patterns among robotic surgeons.
Ann Surg 2018 Feb;267(2):233-35. doi: 10.1097/sla.0000000000002479..
Keywords: Education: Continuing Medical Education, Provider, Practice Patterns, Social Media, Surgery, Training
Wang D
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
The researcher analyzed four interactive case simulation tools (ICSTs) from a statewide online clinical education program. Results have shown that ICSTs are increasingly used by HIV healthcare providers. Smart phone has become the primary usage platform for specific ICSTs. Usage patterns depend on particular ICST modules, usage stages, and use contexts.
AHRQ-funded; HS022057.
Citation: Wang D .
Use contexts and usage patterns of interactive case simulation tools by HIV healthcare providers in a statewide online clinical education program.
Stud Health Technol Inform 2017;245:1242.
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Keywords: Education: Continuing Medical Education, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Provider, Simulation, Training
Juriga LL, Murray DJ, Boulet JR
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Simulation can be used to recreate conditions that engage teams in the diagnostic process. In contrast to most instruction about diagnostic error, teams learn through realistic experiences and receive timely feedback about their decision-making skills. The purpose of this study was to assess how trauma teams (TrT) and pediatric rapid response teams (RRT) managed scenarios that included a diagnostic error.
AHRQ-funded; HS022265; HS018731.
Citation: Juriga LL, Murray DJ, Boulet JR .
Simulation and the diagnostic process: a pilot study of trauma and rapid response teams.
Diagnosis 2017 Nov 27;4(4):241-49. doi: 10.1515/dx-2017-0010..
Keywords: Diagnostic Safety and Quality, Emergency Medical Services (EMS), Injuries and Wounds, Training, Trauma
Branzetti JB, Adedipe AA, Gittinger MJ
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
The purpose of this study was to evaluate the impact of a novel Just-in-Time (JIT) intervention on transvenous pacemaker (TVP) placement during a simulated patient event. The authors concluded that a JIT intervention improved procedure performance, suggesting a role for JIT interventions in rarely performed procedures.
AHRQ-funded; HS020295
Citation: Branzetti JB, Adedipe AA, Gittinger MJ .
Randomised controlled trial to assess the effect of a Just-in-Time training on procedural performance: a proof-of-concept study to address procedural skill decay.
BMJ Qual Saf 2017 Nov;26(11):881-91. doi: 10.1136/bmjqs-2017-006656..
Keywords: Medical Devices, Patient Safety, Surgery, Training, Emergency Medical Services (EMS)
Landsittel DP, Kessler L, Schmid CH
Training in patient-centered outcomes research for specific researcher communities.
A number of publications have discussed approaches to training the scientific workforce in comparative effectiveness research (CER) and patient-centered outcomes research (PCOR). To extend these efforts into specific researcher communities, the AHRQ developed a Funding Opportunity Announcement that called for training for a specific researcher community in collaboration with associated program partners. This paper describes the strategies developed by the 5 subsequently funded programs, and the challenges associated with developing in-person and online programs.
AHRQ-funded; HS023214; HS023199; HS023299; HS023207; HS023185.
Citation: Landsittel DP, Kessler L, Schmid CH .
Training in patient-centered outcomes research for specific researcher communities.
J Clin Transl Sci 2017 Oct;1(5):278-84. doi: 10.1017/cts.2017.307.
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Keywords: Comparative Effectiveness, Evidence-Based Practice, Patient-Centered Outcomes Research, Research Methodologies, Training
Pranaat R, Mohan V, O'Reilly M
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
The objective of the researchers was to develop a virtual video-based simulation to demonstrate and quantify the variability and accuracy of scribes' transcribed notes in the EHR. Their high-fidelity, video-based EHR simulation was able to assess multiple performance indicators in medical scribes and demonstrate significant variability both in terms of structure and accuracy in clinical documentation.
AHRQ-funded; HS025141.
Citation: Pranaat R, Mohan V, O'Reilly M .
Use of simulation based on an electronic health records environment to evaluate the structure and accuracy of notes generated by medical scribes: Proof-of-concept study.
JMIR Med Inform 2017 Sep 20;5(3):e30. doi: 10.2196/medinform.7883.
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Keywords: Electronic Health Records (EHRs), Quality of Care, Patient Safety, Training