National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Burnout (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Diagnostic Safety and Quality (1)
- (-) Education: Continuing Medical Education (14)
- Emergency Medical Services (EMS) (1)
- Imaging (1)
- Outcomes (1)
- Patient and Family Engagement (1)
- Patient Safety (5)
- Provider (3)
- Provider: Physician (4)
- (-) Provider Performance (14)
- Quality Improvement (1)
- Quality Measures (1)
- Quality of Care (2)
- Simulation (2)
- Stress (1)
- Surgery (4)
- Training (7)
- Workforce (1)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 14 of 14 Research Studies DisplayedThelen AE, Kendrick DE, Chen X
Novel method to link surgical trainee performance data to patient outcomes.
A significant roadblock in surgical education research has been the inability to compare trainee performance to the outcomes of those surgeons after they enter independent practice. In this study, the investigators described the feasibility of an innovative method to link trainee performance data with patient outcomes. They indicated that this innovation could enable future research investigating the relationship between surgical trainee performance and patient outcomes in independent practice.
AHRQ-funded; HS027653.
Citation: Thelen AE, Kendrick DE, Chen X .
Novel method to link surgical trainee performance data to patient outcomes.
Am J Surg 2021 Dec;222(6):1072-78. doi: 10.1016/j.amjsurg.2021.10.018..
Keywords: Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Outcomes
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
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, Communication, Patient and Family Engagement, Patient Safety, Education: Continuing Medical Education, Training, Provider Performance
Anton NE, Mizota T, Whiteside JA
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
The authors hypothesize that surgery residents trained on mental skills would outperform controls under increased stress conditions in the simulated operating room. They find that their comprehensive mental skills curriculum implemented with surgery residents at two institutions was effective at minimizing the deterioration of resident technical performance under stressful conditions compared with controls. They conclude that their results provide further evidence for the effectiveness of mental skills training to optimize surgery trainees' technical performance during challenging clinical situations.
AHRQ-funded; R18 HS022080.
Citation: Anton NE, Mizota T, Whiteside JA .
Mental skills training limits the decay in operative technical skill under stressful conditions: results of a multisite, randomized controlled study.
Surgery 2019 Jun;165(6):1059-64. doi: 10.1016/j.surg.2019.01.011..
Keywords: Surgery, Education: Continuing Medical Education, Stress, Provider Performance, Training, Provider: Physician, Provider
Martin JR, Anton N, Timsina L
Performance variability during training on simulators is associated with skill transfer.
Researchers looked at performance variability during training on simulators for performing laparoscopic surgery. Their hypothesis was that participants (surgery residents and medical students) who had consistent scores were most likely to have the most expertise and be capable of training others. The trainees first used the Fundamentals of Laparoscopic Surgery (FLS) simulator to learn laparoscopic suturing and then were transfer tested on a live, anesthetized porcine model. Their hypothesis was proven true and those with decreased practice variability was associated with greater scores in posttests and transfer tests.
AHRQ-funded; R18 HS022080.
Citation: Martin JR, Anton N, Timsina L .
Performance variability during training on simulators is associated with skill transfer.
Surgery 2019 Jun;165(6):1065-68. doi: 10.1016/j.surg.2019.01.013..
Keywords: Simulation, Training, Surgery, Education: Continuing Medical Education, Provider Performance, Provider: Physician, Provider
Sheehan FH, McConnaughey S, Freeman R
Formative assessment of performance in diagnostic ultrasound using simulation and quantitative and objective metrics.
The authors of this article describe how they developed simulator-based tools for assessing provider competence in transthoracic echocardiography (TTE) and vascular duplex scanning. Psychomotor skill in TTE image acquisition was calculated using the deviation angle of an acquired image from the anatomically correct view, and this skill metric applied for formative assessment to evaluate curricula and provide feedback to learners. Psychomotor skill in vascular ultrasound was measured in terms of dexterity and image plane location. The skill metric in the TTE simulator enabled immediate feedback, as well as formative assessment of curriculum efficacy and a comparison of curriculum outcomes. The vascular duplex ultrasound simulator also provided feedback. The authors conclude that skill in acquiring diagnostic ultrasound images of organs and vessels can be measured using simulation in an objective, quantitative, and standardized manner. Simulator-based metrics might also be applied to summative assessment.
AHRQ-funded; HS024219.
Citation: Sheehan FH, McConnaughey S, Freeman R .
Formative assessment of performance in diagnostic ultrasound using simulation and quantitative and objective metrics.
Mil Med 2019 Mar 1;184(Supplement_1):386-91. doi: 10.1093/milmed/usy388.
.
.
Keywords: Diagnostic Safety and Quality, Education: Continuing Medical Education, Imaging, Provider Performance, Training
Cofer KD, Hollis RH, Goss L
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
The purpose of this study was to evaluate whether burnout was associated with emotional intelligence and job performance in surgical residents. The investigators found that burnout was present in surgery residents and was associated with emotional intelligence. There was no association of burnout with United States Medical Licensing Examination scores, American Board of Surgery In-Training Exam percentile, or surgical milestones. The investigators suggested that traditional methods of assessing resident performance may not be capturing burnout and strategies to reduce burnout should consider targeting emotional intelligence.
AHRQ-funded; HS023009.
Citation: Cofer KD, Hollis RH, Goss L .
Burnout is associated with emotional intelligence but not traditional job performance measurements in surgical residents.
J Surg Educ 2018 Sep - Oct;75(5):1171-79. doi: 10.1016/j.jsurg.2018.01.021..
Keywords: Burnout, Education: Continuing Medical Education, Provider, Provider: Physician, Provider Performance
Le Parc JM, Bischof JJ, King AM JM, Bischof JJ, King AM
A randomized comparison of in-hospital rescuer positions for endotracheal intubation in a difficult airway.
The objective of the study was to compare in-hospital emergency medicine (EM) trainees' performance on endotracheal intubation (ETI) delivered from both the seated and standing positions. The study concluded that the position of the in-hospital provider, whether seated or standing, had no effect on the provider's ETI performance. Since environmental circumstances sometimes necessitate alternative positioning for effective ETI administration, the findings suggest that there may be value in training residents to perform ETI from both positions.
AHRQ-funded; HS021456.
Citation: Le Parc JM, Bischof JJ, King AM JM, Bischof JJ, King AM .
A randomized comparison of in-hospital rescuer positions for endotracheal intubation in a difficult airway.
West J Emerg Med 2018 Jul;19(4):660-67. doi: 10.5811/westjem.2018.4.37227..
Keywords: Education: Continuing Medical Education, Emergency Medical Services (EMS), Patient Safety, Provider Performance
Sheehan FH, Zierler RE
Simulation for competency assessment in vascular and cardiac ultrasound.
This paper discusses the use of simulation for competency-based medical education (CBME) in diagnostic ultrasound. The authors suggest that the use of simulation for CBME in diagnostic ultrasound is particularly appealing since it incorporates both the psychomotor and cognitive domains while eliminating dependency on the availability of live patients with a range of pathology. However, successful application of simulation in this setting requires realistic, full-featured simulators and appropriate standardized metrics for competency testing.
AHRQ-funded; HS024219.
Citation: Sheehan FH, Zierler RE .
Simulation for competency assessment in vascular and cardiac ultrasound.
Vasc Med 2018 Apr;23(2):172-80. doi: 10.1177/1358863x17751656..
Keywords: Education: Continuing Medical Education, Provider Performance
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
Barsuk JH, Cohen ER, Williams MV
The effect of simulation-based mastery learning on thoracentesis referral patterns.
This study aimed to (1) assess the effect of simulation-based mastery learning (SBML) on internal medicine residents' simulated thoracentesis skills and (2) compare thoracentesis referral patterns, self-confidence, and reasons for referral between traditionally trained residents (non-SBML-trained), SBML-trained residents, and hospitalist physicians. This study identified confidence and time as reasons physicians refer thoracenteses rather than perform them at the bedside.
AHRQ-funded; HS021202.
Citation: Barsuk JH, Cohen ER, Williams MV .
The effect of simulation-based mastery learning on thoracentesis referral patterns.
J Hosp Med 2016 Nov;11(11):792-95. doi: 10.1002/jhm.2623..
Keywords: Education: Continuing Medical Education, Provider Performance, Training
Klerman EB, Beckett SA, Landrigan CP
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
Using a mathematical model of the effects of circadian rhythms and length of time awake on objective performance and subjective alertness, the researchers compared predictions for traditional intern schedules to those that limit work to </= 16 consecutive hours. Their model predicted fewer hours with poor performance and alertness, especially during night-time work hours, for all three novel schedules than for either of the two traditional schedules.
AHRQ-funded; HS017357.
Citation: Klerman EB, Beckett SA, Landrigan CP .
Applying mathematical models to predict resident physician performance and alertness on traditional and novel work schedules.
BMC Med Educ 2016 Sep 13;16(1):239. doi: 10.1186/s12909-016-0751-9.
.
.
Keywords: Education: Continuing Medical Education, Patient Safety, Provider Performance, Workforce
Calaman S, Hepps JH, Bismilla Z
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
The authors report their experience developing videos that represent five levels of performance for an entrustable professional activities (EPA) for patient handoffs. They describe a process that begins with mapping the EPA to the critical competencies needed to make an entrustment decision. Each competency is then defined by five milestones (behavioral descriptors of performance at five advancing levels).
AHRQ-funded; HS019456.
Citation: Calaman S, Hepps JH, Bismilla Z .
The creation of standard-setting videos to support faculty observations of learner performance and entrustment decisions.
Acad Med 2016 Feb;91(2):204-9. doi: 10.1097/acm.0000000000000853..
Keywords: Education: Continuing Medical Education, Provider Performance, Patient Safety, Quality of Care
Arora VM, Berhie S, Horwitz LI
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
The researchers report the results of the development of a shorter Handoff Mini-Clinical Examination Exercise (CEX), along with the formal establishment of its construct validity, namely its ability to distinguish between levels of performance in 3 domains of handoff quality. They were able to demonstrate evidence that the Handoff Mini-CEX can draw reliable and valid conclusions regarding handoff performance by physicians in U.S. hospitals.
AHRQ-funded; HS018278
Citation: Arora VM, Berhie S, Horwitz LI .
Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise.
J Hospital Med. 2014 Jul;9(7):441-6. doi: 10.1002/jhm.2185.
.
.
Keywords: Provider Performance, Quality Measures, Quality Improvement, Quality of Care, Education: Continuing Medical Education, Patient Safety