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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 25 of 140 Research Studies Displayed
Baughman AW, Renton M, Wehbi NK
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
Researchers discuss the partnership of the Massachusetts Senior Care Association and Hebrew SeniorLife with AHRQ ECHO National Nursing Home COVID-19 Action Network (the Network). This educational program provided 16 weeks of free weekly virtual sessions to 295 eligible nursing homes. The Network weekly meetings were a source of connection, emotional support, and validation and may be a valuable mechanism to support resilience and wellbeing for nursing home staff.
AHRQ-funded; 75Q80120C00003.
Citation:
Baughman AW, Renton M, Wehbi NK .
Building community and resilience in Massachusetts nursing homes during the COVID-19 pandemic.
J Am Geriatr Soc 2021 Oct;69(10):2716-21. doi: 10.1111/jgs.17389..
Keywords:
COVID-19, Elderly, Nursing Homes, Evidence-Based Practice, Provider: Health Personnel, Education: Continuing Medical Education, Training
Naderi R, Oberndorfer TA, Jordan SR
Resident perspectives on the value of interdisciplinary conference calls for geriatric patients.
The University of Colorado implemented a virtual interdisciplinary conference call, TEAM (Transitions Expectation and Management), between providers on the inpatient Acute Care of the Elder (ACE) unit and the outpatient Seniors Clinic at the University of Colorado Hospital. This study highlighted learner perspectives of the benefit of interdisciplinary conference calls between inpatient and outpatient providers to enhance transitions of care, which provided meaningful feedback and served as a vehicle for residents to recognize the impact of their care decisions in the broader spectrum of patients' experience during hospital discharge.
AHRQ-funded; HS024569.
Citation:
Naderi R, Oberndorfer TA, Jordan SR .
Resident perspectives on the value of interdisciplinary conference calls for geriatric patients.
BMC Med Educ 2021 Jun 3;21(1):314. doi: 10.1186/s12909-021-02750-4..
Keywords:
Elderly, Education: Continuing Medical Education, Transitions of Care
Sinz E, Banerjee A, Steadman R
Reliability of simulation-based assessment for practicing physicians: performance is context-specific.
Even physicians who routinely work in complex, dynamic practices may be unprepared to optimally manage challenging critical events. High-fidelity simulation can realistically mimic critical clinically relevant events, however the reliability and validity of simulation-based assessment scores for practicing physicians has not been established. In this study, standardised complex simulation scenarios were developed and administered to board-certified, practicing anesthesiologists who volunteered to participate in an assessment study during formative maintenance of certification activities.
AHRQ-funded; HS020415.
Citation:
Sinz E, Banerjee A, Steadman R .
Reliability of simulation-based assessment for practicing physicians: performance is context-specific.
BMC Med Educ 2021 Apr 12;21(1):207. doi: 10.1186/s12909-021-02617-8..
Keywords:
Simulation, Education: Continuing Medical Education, Training, Provider Performance
Williams C, Familusi OO, Ziemba J
Adapting to the educational challenges of a pandemic: development of a novel virtual urology subinternship during the time of COVID-19.
The purpose of this study was to design, implement, and evaluate learner attitudes of a virtual urologic surgery clinical rotation for medical students. The investigators concluded that virtual medical student rotations were scalable and effective at delivering surgical material and could approximate the interpersonal teaching found in clinical learning environments. The investigators suggested that they may be a useful tool to supplement or augment clinical learning in select situations.
AHRQ-funded; HS026372.
Citation:
Williams C, Familusi OO, Ziemba J .
Adapting to the educational challenges of a pandemic: development of a novel virtual urology subinternship during the time of COVID-19.
Urology 2021 Feb;148:70-76. doi: 10.1016/j.urology.2020.08.071..
Keywords:
Education: Curriculum, COVID-19, Surgery, Education: Continuing Medical Education
Larsen GY, Brilli R, Macias CG
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Researchers developed a multicenter quality improvement learning collaborative of US children's hospitals. They created a key driver diagram (KDD) with the aim of reducing both the sepsis-attributable mortality and the incidence of hospital-onset sepsis in children. The KDD primary drivers focused on improving the following: treatment of infection; recognition, diagnosis, and treatment of sepsis; de-escalation of unnecessary care; engagement of patients and families; and methods to optimize performance. The Children's Hospital Association Improving Pediatric Sepsis Outcomes collaborative aims to improve sepsis outcomes through collaborative learning and reliable implementation of evidence-based interventions.
AHRQ-funded; HS025696.
Citation:
Larsen GY, Brilli R, Macias CG .
Development of a quality improvement learning collaborative to improve pediatric sepsis outcomes.
Pediatrics 2021 Jan;147(1). doi: 10.1542/peds.2020-1434..
Keywords:
Children/Adolescents, Sepsis, Outcomes, Quality Improvement, Quality of Care, Education: Continuing Medical Education
Branca A, Tellez D, Berkenbosch J
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Researchers evaluated the effect of the timing of the PICU fellow academic cycle on tracheal intubation-associated events in a retrospective cohort study of 37 PICUs participating in the National Emergency Airway Registry for Children.. They found that the New Trainee Effect in tracheal intubation safety outcomes was not observed in various types of PICUs. There was a significant improvement in pediatric critical care medicine fellows' first attempt success and a significant decline in tracheal intubation-associated event rates, indicating substantial skills acquisition throughout pediatric critical care medicine fellowship.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation:
Branca A, Tellez D, Berkenbosch J .
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2020 Dec;21(12):1042-50. doi: 10.1097/pcc.0000000000002480..
Keywords:
Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Registries, Education: Continuing Medical Education, Training
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
Lim H, Raffel KE, Harrison JD
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
An educational intervention was created for medical residents during night float rotations where they admit patients to the hospital. The intervention was designed to provide feedback on their diagnostic and management reasoning using feedback solicitation and chart review. Second- and third-year internal medicine residents on a 1-month night float rotation were recruited. Residents performed chart review of a subset of patients they admitted and completed reflection worksheets detailing patients’ clinical courses. Sixty-eight of 82 eligible residents participated in the intervention. The authors evaluated 248 reflection worksheets using content analysis. Major themes that emerged from chart review included residents’ identification of reasoning gaps and evaluation of resident-provider interactions.
AHRQ-funded; HS026383.
Citation:
Lim H, Raffel KE, Harrison JD .
Decisions in the dark: an educational intervention to promote reflection and feedback on night float rotations.
J Gen Intern Med 2020 Nov;35(11):3363-67. doi: 10.1007/s11606-020-05913-z..
Keywords:
Provider: Physician, Provider, Education: Continuing Medical Education, Decision Making
Brown W, Santhosh L, Brady AK
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
This article presents a review of endotracheal intubation (EI) training for healthcare professionals in pulmonary and critical care medicine (PCCM). Although the ACGME mandates that trainees in PCCM achieve competence, only 60% of US PCCM trainees feel they are proficient in EI upon graduation. This article includes a review of EI training literature; the recommendations of a national group of PCCM, anesthesiology, emergency medicine, and pediatric experts; and a call for further research, collaboration, and consensus guidelines.
Citation:
Brown W, Santhosh L, Brady AK .
A call for collaboration and consensus on training for endotracheal intubation in the medical intensive care unit.
Crit Care 2020 Oct 22;24(1):621. doi: 10.1186/s13054-020-03317-3..
Keywords:
Training, Education: Continuing Medical Education, Critical Care, Intensive Care Unit (ICU), Guidelines
Glass M, Rana S, Coghlan R
Global palliative care education in the time of COVID-19.
This paper describes the Global Palliative Education Collaborative (GPEC), which is a training partnership between Harvard, University of California San Francisco, and Tulane medical schools in the U.S., and international palliative care (PC) programs in Uganda and India. U.S.-based fellowships are offered by GPEC to learn about resource-limited PC provision, gain perspectives on global challenges to caring for patients at the end of life, and cultivate resiliency. They also offer a novel educational project that the GPEC faculty and fellows are participating in called the Resilient Inspirational Storytelling Empathy Project. Palliative care has become even more important during the COVID-19 pandemic.
AHRQ-funded; HS026383.
Citation:
Glass M, Rana S, Coghlan R .
Global palliative care education in the time of COVID-19.
J Pain Symptom Manage 2020 Oct;60(4):e14-e19. doi: 10.1016/j.jpainsymman.2020.07.018..
Keywords:
Palliative Care, COVID-19, Education: Continuing Medical Education, Training
Zittleman L, Curcija K, Sutter C
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
In response to rural communities and practice concerns related to opioid use disorder (OUD), the Implementing Technology and Medication Assisted Treatment Team Training in Rural Colorado study (IT MATTTRs) developed a training intervention for full primary care practice (PCP) teams in MAT for OUD. This evaluation reports on training implementation, participant satisfaction, and impact on perceived ability to deliver MAT.
AHRQ-funded; HS025065.
Citation:
Zittleman L, Curcija K, Sutter C .
Building capacity for medication assisted treatment in rural primary care Practices: the IT MATTTRs practice team training.
J Prim Care Community Health 2020 Jan-Dec;11:2150132720953723. doi: 10.1177/2150132720953723..
Keywords:
Medication, Primary Care, Opioids, Substance Abuse, Rural Health, Training, Education: Continuing Medical Education
Huth K, Amar-Dolan L, Perez JM
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
This study’s objective was to evaluate the impact of participation in a virtual home visit curriculum on pediatric residents’ confidence, knowledge, and application of knowledge in caring for children with medical complexity (CMC) in the home and community. This prospective pre-post intervention study was conducted in 2019 with first-year pediatric residents using quantitative and qualitative methods. The intervention used was an online video-based curriculum followed by an in-person seminar. Twenty-four residents participated. All reported increased confidence in all aspects of complex care presented in the curriculum. Half of them (12) participated in a follow-up interview or focus group. Four themes identified were: 1) recognizing prior attitudes towards complexity; 2) new mental framework for mental care at home; 3) drivers of behavior change; and 4) commitment to change practice.
AHRQ-funded; HS000063.
Citation:
Huth K, Amar-Dolan L, Perez JM .
Visiting Jack: mixed methods evaluation of a virtual home visit curriculum with a child with medical complexity.
Acad Pediatr 2020 Sep-Oct;20(7):1020-28. doi: 10.1016/j.acap.2020.05.001..
Keywords:
Children/Adolescents, Telehealth, Health Information Technology (HIT), Chronic Conditions, Education: Continuing Medical Education
Khorfan R, Yuce TK, Love R
Cumulative effect of flexible duty-hour policies on resident outcomes: long-term follow-up results from the FIRST trial.
The authors investigated the long-term effect of flexible duty-hour policies on resident outcomes. They found that cumulative time under flexible duty-hour policies had no detrimental effects on duty-hour violations or resident well-being. After multiple years of flexibility, residents continue to report a high rate of satisfaction and positive effects on continuity of care.
Citation:
Khorfan R, Yuce TK, Love R .
Cumulative effect of flexible duty-hour policies on resident outcomes: long-term follow-up results from the FIRST trial.
Ann Surg 2020 May;271(5):791-98. doi: 10.1097/sla.0000000000003802..
Keywords:
Education: Continuing Medical Education, Patient Safety, Provider: Physician, Provider, Surgery
McCarthy DM, Powell RE, Cameron KA
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
The purpose of this study was to evaluate the effectiveness of the Uncertainty Communication Education Module (UCEM) in improving physician communications. Patients' understanding of the care they received has implications for care quality, safety, and patient satisfaction, especially when they are discharged without a definitive diagnosis. Developing a patient-centered diagnostic uncertainty communication strategy will improve safety of acute care discharges. This trial has been designed to have a low-resource, scalable intervention that would allow for widespread dissemination and uptake.
AHRQ-funded; HS025651.
Citation:
McCarthy DM, Powell RE, Cameron KA .
Simulation-based mastery learning compared to standard education for discussing diagnostic uncertainty with patients in the emergency department: a randomized controlled trial.
BMC Med Educ 2020 Feb 19;20(1):49. doi: 10.1186/s12909-020-1926-y..
Keywords:
Education: Continuing Medical Education, Clinician-Patient Communication, Communications, Emergency Department, Simulation, Provider: Physician, Provider
Salzman DH, Rising KL, Cameron KA
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
Historically, medically trained experts have served as judges to establish a minimum passing standard (MPS) for mastery learning. As mastery learning expands from procedure-based skills to patient-centered domains, such as communication, there is an opportunity to incorporate patients as judges in setting the MPS. In this study, the investigators described their process of incorporating patients as judges to set the minimum passing standard (MPS) and compared the MPS set by patients and emergency medicine residency program directors (PDs).
AHRQ-funded; HS025651.
Citation:
Salzman DH, Rising KL, Cameron KA .
Setting a minimum passing standard for the uncertainty communication checklist through patient and physician engagement.
J Grad Med Educ 2020 Feb;12(1):58-65. doi: 10.4300/jgme-d-19-00483.1..
Keywords:
Clinician-Patient Communication, Communications, Patient and Family Engagement, Patient Safety, Education: Continuing Medical Education, Training, Provider Performance
Ellis RJ, Holmstrom AL, Hewitt DB
A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training.
This survey examined reasons why general surgery residents might decide to leave their residency. The survey was administered with the 2018 American Board of Surgery In-Training Examination. Among 7,409 residents surveyed, 12.6% considered leaving residency over the last year. Almost half were considering other specialties if they were dissatisfied being a surgeon. Women were also more likely to consider leaving medicine. Common reasons for remaining in residency included the feeling of too large an investment to leave (65.3%) and career satisfaction (55%).
AHRQ-funded; HS000078; HS023011.
Citation:
Ellis RJ, Holmstrom AL, Hewitt DB .
A comprehensive national survey on thoughts of leaving residency, alternative career paths, and reasons for staying in general surgery training.
Am J Surg 2020 Feb;219(2):227-32. doi: 10.1016/j.amjsurg.2019.10.040..
Keywords:
Education: Continuing Medical Education, Surgery
Anton NE, Bean EA, Myers E
Optimizing learner engagement during mental skills training: a pilot study of small group vs. individualized training.
This study compared small group versus individualized training results for a group of residents learning laparoscopic suturing. Residents at one institution completed small group training and the second institution completed individualized training. After mental skills training, the completed FLS training at which time they completed the Short State Stress Questionnaire detailing the training. Twenty-one residents completed the training. Individualized training showed greater engagement and mental skills than small group training.
AHRQ-funded; HS022080.
Citation:
Anton NE, Bean EA, Myers E .
Optimizing learner engagement during mental skills training: a pilot study of small group vs. individualized training.
Am J Surg 2020 Feb;219(2):335-39. doi: 10.1016/j.amjsurg.2019.12.022..
Keywords:
Training, Education: Continuing Medical Education, Simulation, Surgery, Education: Curriculum
Michelson KA, Nigrovic LE, Nagler J
Research interest in pediatric emergency medicine fellows.
The authors sought to determine the prevalence and determinants of interest in research careers among pediatric emergency medicine (PEM) fellows. They performed an electronically distributed national survey of current PEM fellows, assessing demographics, barriers to successful research, and beliefs about research using 4-point ordinal scales. The authors found that most fellows expect to devote a minority of their career to clinical research. Enthusiasm about research was strongly correlated with career research interest.
AHRQ-funded; HS000063.
Citation:
Michelson KA, Nigrovic LE, Nagler J .
Research interest in pediatric emergency medicine fellows.
Pediatr Emerg Care 2020 Feb;36(2):e38-e42. doi: 10.1097/pec.0000000000001085..
Keywords:
Emergency Department, Children/Adolescents, Health Services Research (HSR), Provider: Physician, Provider, Education: Continuing Medical Education
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
Elkhadragy N, Corelli RL, Russ AL
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Researchers conducted a long-term, qualitative follow-up study of faculty participants in the Rx for Change: Clinician-Assisted Tobacco Cessation workshop. All study participants reported implementing components of Rx for Change at their institution. The researchers’ analysis yielded eight major themes pertaining to faculty perceptions and experiences with implementation. They found that participation in the train-the-trainer workshop increased self-reported confidence for teaching tobacco cessation, and faculty valued access to useful, updated tools for teaching. Furthermore, the newly-acquired counseling skills were deemed helpful for treating patients' tobacco use and dependence in clinical practice.
AHRQ- funded; HS022119.
Citation:
Elkhadragy N, Corelli RL, Russ AL .
Faculty perceptions of a tobacco cessation train-the-trainer workshop and experiences with implementation: a qualitative follow-up study.
Res Social Adm Pharm 2019 Dec;15(12):1436-45. doi: 10.1016/j.sapharm.2019.01.005..
Keywords:
Tobacco Use: Smoking Cessation, Tobacco Use, Education: Continuing Medical Education
Chan B, Lyles C, Kaplan C
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
In this study, the authors investigated differences in overall and patterns of portal use for patients with resident and attending primary care providers (PCPs). They concluded that given the lower patient-portal use among residents' patients, residency programs should develop curricula to bolster trainee competence in using the patient-portal for communication and to enhance the patient-physician relationship.
AHRQ-funded; HS022981; HS022408.
Citation:
Chan B, Lyles C, Kaplan C .
A comparison of electronic patient-portal use among patients with resident and attending primary care providers.
J Gen Intern Med 2018 Dec;33(12):2085-91. doi: 10.1007/s11606-018-4637-x..
Keywords:
Clinician-Patient Communication, Education: Continuing Medical Education, Electronic Health Records (EHRs), Health Information Technology (HIT), Primary Care, Provider, Provider: Physician
Yang AD, Quinn CM, Hewitt DB
National evaluation of needlestick events and reporting among surgical residents.
Needlestick injuries pose significant health hazards; however, the nationwide frequency of needlesticks and reporting practices among surgical residents are unknown. The objectives of this study were to examine the rate and circumstances of self-reported needlestick events in US surgery residents, assess factors associated with needlestick injuries, evaluate reporting practices, and identify reporting barriers.
AHRQ-funded; HS000078.
Citation:
Yang AD, Quinn CM, Hewitt DB .
National evaluation of needlestick events and reporting among surgical residents.
J Am Coll Surg 2019 Dec;229(6):609-20. doi: 10.1016/j.jamcollsurg.2019.09.001..
Keywords:
Education: Continuing Medical Education, Surgery, Injuries and Wounds, Provider
Hu YY, Ellis RJ, Hewitt DB
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
A cross-sectional national survey of general surgery residents, administered with the 2018 American Board of Surgery In-Training Examination, assessed mistreatment, burnout, and suicidal thoughts during the past year. The authors assessed the association of mistreatment with burnout and suicidal thoughts; they found that mistreatment occurs frequently among general surgery residents, especially women, and is associated with burnout and suicidal thoughts.
AHRQ-funded; HS000078.
Citation:
Hu YY, Ellis RJ, Hewitt DB .
Discrimination, Abuse, Harassment, and Burnout in Surgical Residency Training.
N Engl J Med 2019 Oct 31;381(18):1741-52. doi: 10.1056/NEJMsa1903759..
Keywords:
Education: Continuing Medical Education, Burnout, Stress, Surgery, Provider: Physician, Provider, Training
Long SA, Thomas G, Karam MD
Do skills acquired from training with a wire navigation simulator transfer to a mock operating room environment?
This study compared performance of residents getting traditional and simulation orthopedic surgery training at three medical centers: University of Iowa, University of Minnesota, and the Mayo Clinic. All residents first received traditional training in how to treat an intertrochanteric fracture. Then the groups were divided up with two groups getting additional simulated-based training and another group getting proficiency training for specific components of wire navigation. The two simulation-based training groups performed better in lower tip-apex distance than the traditional training group. Residents in the proficiency training group used more images than the other groups.
AHRQ-funded; HS022077; HS025353.
Citation:
Long SA, Thomas G, Karam MD .
Do skills acquired from training with a wire navigation simulator transfer to a mock operating room environment?
Clin Orthop Relat Res 2019 Oct;477(10):2189-98. doi: 10.1097/corr.0000000000000799..
Keywords:
Simulation, Training, Education: Continuing Medical Education, Surgery, Orthopedics
Cook JM, Newman E, Simiola V
Trauma training: competencies, initiatives, and resources.
Traumatic stress is currently not a required component of the standard curricula in graduate-level education in clinical and counseling psychology. However, due to the high prevalence of trauma and its potentially deleterious physical and mental health effects in the general and clinical populations, it is imperative that psychology graduate students and practitioners understand the relevance of trauma in their clients' lives and its impact in clinical research. This paper discusses competencies, initiatives and resources related to trauma training.
AHRQ-funded; HS021602.
Citation:
Cook JM, Newman E, Simiola V .
Trauma training: competencies, initiatives, and resources.
Psychotherapy 2019 Sep;56(3):409-21. doi: 10.1037/pst0000233..
Keywords:
Education: Continuing Medical Education, Behavioral Health, Provider, Stress, Training, Trauma
