Featured Publications
Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice
Wong AH, Ray JM, Eixenberger C, Crispino LJ, Parker JB, Rosenberg A, Robinson L, McVaney C, Iennaco JD, Bernstein SL, Yonkers KA, Pavlo AJ. Qualitative study of patient experiences and care observations during agitation events in the emergency department: implications for systems-based practice. BMJ Open 2022, 12: e059876. PMID: 35545394, PMCID: PMC9096567, DOI: 10.1136/bmjopen-2021-059876.Peer-Reviewed Original ResearchConceptsEmergency departmentAgitation eventsQualitative studyEmergency careQualitative studies of patients' experiencesPhysical restraintStudies of patients' experiencesAvoidance of physical restraintSystem of healthcare deliveryPhysical restraint useEmergency care networkCommunity-based teaching hospitalSystems-based practiceTertiary care academic centreInterviews of patientsVerbal de-escalationGrounded theory approachPatient-oriented strategiesExposure to psychological traumaExcessive psychomotor activityCare approachSocioeconomic inequalitiesPatient experienceRestraint useCare networkRacial and Ethnic Disparities in Physical Restraint Use for Pediatric Patients in the Emergency Department
Nash KA, Tolliver DG, Taylor RA, Calhoun AJ, Auerbach MA, Venkatesh AK, Wong AH. Racial and Ethnic Disparities in Physical Restraint Use for Pediatric Patients in the Emergency Department. JAMA Pediatrics 2021, 175: 1283-1285. PMID: 34515764, PMCID: PMC8438617, DOI: 10.1001/jamapediatrics.2021.3348.Peer-Reviewed Original ResearchDisparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department
Haimovich A, Taylor R, Chang-Sing E, Brashear T, Cramer L, Lopez K, Wong A. Disparities Associated With Electronic Behavioral Alerts for Safety and Violence Concerns in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 100-107. PMID: 37269262, PMCID: PMC10689576, DOI: 10.1016/j.annemergmed.2023.04.004.Peer-Reviewed Original ResearchConceptsHealth care systemEmergency departmentPatient-level analysisCare systemED visitsLeft-without-being-seenNegative perceptions of patientsElectronic health record dataUnited States health care systemRegional health care systemStates health care systemDiscontinuity of careHealth record dataElectronic health recordsBlack non-Hispanic patientsPerceptions of patientsBlack non-HispanicRetrospective cross-sectional study of adult patientsAdult emergency departmentNon-Hispanic patientsCross-sectional study of adult patientsMixed-effects regression analysisStudy periodRetrospective cross-sectional studyCare deliveryRacial Inequities in Police Transport for Patients to the Emergency Department: A Multicenter Analysis
Gagliardi J, Smith C, Chang-Sing E, Cramer L, Robinson L, Shah D, Jivalagian P, Turner N, Wong A. Racial Inequities in Police Transport for Patients to the Emergency Department: A Multicenter Analysis. American Journal Of Preventive Medicine 2023, 66: 154-158. PMID: 37661074, PMCID: PMC10842350, DOI: 10.1016/j.amepre.2023.08.018.Peer-Reviewed Original ResearchConceptsEmergency medical careEmergency departmentPolice transportMedical careRacial inequalityElectronic health recordsAdult emergency department visitsRegional hospital systemBehavioral health diagnosesEmergency department visitsAssociated with increased oddsAdult emergency department (ED) visitsCross-sectional studyDrivers of inequalityInfluences clinical outcomeVisit characteristicsHealth recordsDifferent emergency departmentsDepartment visitsMultivariable mixed modelsSubstance use disordersHealth diagnosisHospital systemPatient transportMultivariate mixed models
2024
Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study
Fults E, Gerwin J, Boyce M, Joseph M, Wong A, Evans L. Educational and personal impacts of the COVID-19 pandemic on emergency medicine resident physicians: a qualitative study. BMC Medical Education 2024, 24: 1055. PMID: 39334215, PMCID: PMC11429862, DOI: 10.1186/s12909-024-05972-4.Peer-Reviewed Original ResearchConceptsEmergency medicine resident physiciansResident physiciansQualitative studyEmergency departmentResident physicians' experiencesEmergency medicine facultyCOVID-19 pandemicResident physician trainingResidency program leadershipSocial support systemsBackgroundThe COVID-19 pandemicData saturationPhysician trainingCode teamFrontline physiciansPractice styleUrban academic institutionProgram leadershipPhysician experienceMedicine facultyResident experiencePersonal impactPhysiciansMoral injuryResident preparationComparing Male and Female Resident Physicians in Central Venous Catheter Insertion Self-confidence and Competency: A Retrospective Cohort Study
Solberg M, Wong A, Ikejiani S, Bonz J, Evans L. Comparing Male and Female Resident Physicians in Central Venous Catheter Insertion Self-confidence and Competency: A Retrospective Cohort Study. Journal Of General Internal Medicine 2024, 1-7. PMID: 39117882, DOI: 10.1007/s11606-024-08982-6.Peer-Reviewed Original ResearchTraining programPost-trainingCentral venous catheterFemale resident physiciansSelf-confidenceSelf-reported confidenceMale traineesDifferences pre-Simulation training programVenous cathetersCannulation attemptsDesigning training programsPhysician residentsInserting central venous cathetersSkill-based outcomesLinear regressionDesignUsing dataMale physiciansResident physiciansCentral venous catheter insertionRetrospective cohort studyClinical competenceSpecialty designationBaseline demographic characteristicsPhysician educationAssessment of an organizational effort to increase emergency medicine faculty on National Institutes of Health study sections
Pulcini C, Barton D, Cassara M, Davis J, DeMasi S, Durant E, Garg N, Greineder C, McMillian M, Paxton J, Puskarich M, Vogel J, Wong A, Sharp W. Assessment of an organizational effort to increase emergency medicine faculty on National Institutes of Health study sections. Academic Emergency Medicine 2024 PMID: 39056157, DOI: 10.1111/acem.14993.Peer-Reviewed Original ResearchRacial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department
Jivalagian P, Gettel C, Smith C, Robinson L, Brinker M, Shah D, Kumar A, Faustino I, Nath B, Chang-Sing E, Taylor R, Kennedy M, Hwang U, Wong A. Racial, Ethnic, and Age-Related Disparities in Sedation and Restraint Use for Older Adults in the Emergency Department. American Journal Of Geriatric Psychiatry 2024 PMID: 39054237, DOI: 10.1016/j.jagp.2024.07.004.Peer-Reviewed Original ResearchPhysical restraint useRestraint useOlder adultsED visitsPhysical restraintEmergency departmentElectronic health record dataHealth record dataBlack non-HispanicPatient-level characteristicsAge-related disparitiesAssociated with increased useRegional hospital networkCross-sectional studyLogistic regression modelsChemical sedationRetrospective cross-sectional studyNon-Hispanic groupNon-HispanicAgitation managementHospital sitesHospital networkRecord dataWhite non-Hispanic groupPrimary outcomeApplying simulation learning theory to identify instructional strategies for Generation Z emergency medicine residency education
Hrdy M, Tarver E, Lei C, Moss H, Wong A, Moadel T, Beattie L, Lamberta M, Cohen S, Cassara M, Hughes M, De Castro A, Sahi N, Chen T. Applying simulation learning theory to identify instructional strategies for Generation Z emergency medicine residency education. AEM Education And Training 2024, 8: s56-s69. PMID: 38774828, PMCID: PMC11102949, DOI: 10.1002/aet2.10981.Peer-Reviewed Original ResearchGeneration Z learnersInstructional strategiesLearning preferencesSimulation-based educationLearning environmentLearning theoryInteractive small-group learningStudent-centered educationSmall group learningVisual learning environmentEffective educational strategiesSelf-paced learningClinical learning environmentDeliver effective educationEducational innovationInstructional landscapeEducational environmentAcademic supportAsynchronous educationEducational allianceEffective educationDidactic environmentEducational strategiesMultimedia designEducationThe MIDAS touch: Frameworks for procedural model innovation and validation
Stapleton S, Cassara M, Roth B, Matulis C, Desmond C, Wong A, Cardell A, Moadel T, Lei C, Munzer B, Moss H, Nadir N. The MIDAS touch: Frameworks for procedural model innovation and validation. AEM Education And Training 2024, 8: s24-s35. PMID: 38774824, PMCID: PMC11102942, DOI: 10.1002/aet2.10980.Peer-Reviewed Original ResearchModel creationProcedural modelNovel modelMinimization frameworkDevelopment expertiseMidas touchValidation processModel innovationLow timeSimulation communityFrameworkEducational outcomesTraining qualityEngineering fieldsSimulationistsWorking GroupDevelopment of modelsImproved modelTrainingProcedural practicesSkills trainingSimulationStandard approachWorkshop participantsPreconference workshopHuman-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System
Rajashekar N, Shin Y, Pu Y, Chung S, You K, Giuffre M, Chan C, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, Kizilcec R, Laine L, Mccall T, Shung D. Human-Algorithmic Interaction Using a Large Language Model-Augmented Artificial Intelligence Clinical Decision Support System. 2024, 1-20. DOI: 10.1145/3613904.3642024.Peer-Reviewed Original ResearchClinical decision support systemsHuman-computer interactionDecision support systemArtificial intelligenceAI-CDSSIntelligent clinical decision support systemSupport systemIntegration of artificial intelligenceHuman-algorithm interactionsEase-of-useLanguage modelHuman algorithmAI systemsSocio-technological challengesHealth-care providersMedical student participationQualitative themesClinical simulationClinical expertiseUpper gastrointestinal bleedingUsabilityBorderline decisionsLanguageClinical intuitionTrust407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY
Chung S, Rajashekar N, Pu Y, Shin Y, Giuffrè M, Chan C, You K, Saarinen T, Hsiao A, Sekhon J, Wong A, Evans L, McCall T, Kizilcec R, Laine L, Shung D. 407 IMPACT OF ARTIFICIAL INTELLIGENCE SYSTEMS FOR UPPER GASTROINTESTINAL BLEEDING ON CLINICIAN TRUST AND LEARNING USING LARGE LANGUAGE MODELS: A RANDOMIZED PILOT SIMULATION STUDY. Gastroenterology 2024, 166: s-95-s-96. DOI: 10.1016/s0016-5085(24)00715-7.Peer-Reviewed Original ResearchHRVEST: a novel data solution for using wearable smart technology to measure physiologic stress variables during a randomized clinical trial
Gerwin J, de Oliveira Almeida G, Boyce M, Joseph M, Wong A, Burleson W, Evans L. HRVEST: a novel data solution for using wearable smart technology to measure physiologic stress variables during a randomized clinical trial. Frontiers In Computer Science 2024, 6: 1343139. DOI: 10.3389/fcomp.2024.1343139.Peer-Reviewed Original ResearchWearable smart garmentsSmart garmentsNovel algorithmRaw physiological dataData solutionsElectrocardiogram (ECGData processing algorithmsReal-time feedbackWearable technologyBiometric dataNoise-filteringProprietary softwareProposed solutionsData challengeSmart technologiesRaw dataAlgorithmDataAnalytical softwareSoftwarePhysiological dataTechnologyBreak-takingDecision-makingHeart rate variabilityFormative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol
Wong A, Nath B, Shah D, Kumar A, Brinker M, Faustino I, Boyce M, Dziura J, Heckmann R, Yonkers K, Bernstein S, Adapa K, Taylor R, Ovchinnikova P, McCall T, Melnick E. Formative evaluation of an emergency department clinical decision support system for agitation symptoms: a study protocol. BMJ Open 2024, 14: e082834. PMID: 38373857, PMCID: PMC10882402, DOI: 10.1136/bmjopen-2023-082834.Peer-Reviewed Original ResearchConceptsComputerised clinical decision supportED treatRestraint useExperiences of restraint useMental health-related visitsEmergency departmentPrevent agitationSystems-related factorsImprove patient experienceClinical decision support systemsRegional health systemClinical decision supportDe-escalation techniquesRandomised controlled trialsFormative evaluationPeer-reviewed journalsBest-practice guidanceAt-risk populationsCDS toolsThematic saturationED cliniciansPatient experienceED sitesHealth systemED physiciansThe impact of interviewer characteristics on residency candidate scores in Emergency Medicine: a brief report
Coughlin R, Bod J, Wood D, Goldflam K, Della-Giustina D, Joseph M, Devlin D, Wong A, Tsyrulnik A. The impact of interviewer characteristics on residency candidate scores in Emergency Medicine: a brief report. MedEdPublish 2024, 13: 205. PMID: 38481470, PMCID: PMC10933563, DOI: 10.12688/mep.19735.2.Peer-Reviewed Original ResearchGroup discussionsScore changesCross-sectional observational studyInterviewer characteristicsLogistic regression modelsEmergency medicineBourdieu's social capital theoryUniversity SchoolObservational studyOddsResidency candidatesRegression modelsInterviewsPost-discussionInterview dayResidentsScoresIndividual scoresAcademic rankScore interactionResidency matchBrief reportEmergencyFaculty interviewsRacial and Ethnic Disparities in Patient Restraint in Emergency Departments by Police Transport Status
Chang-Sing E, Smith C, Gagliardi J, Cramer L, Robinson L, Shah D, Brinker M, Jivalagian P, Hu Y, Turner N, Wong A. Racial and Ethnic Disparities in Patient Restraint in Emergency Departments by Police Transport Status. JAMA Network Open 2024, 7: e240098. PMID: 38381433, PMCID: PMC10882414, DOI: 10.1001/jamanetworkopen.2024.0098.Peer-Reviewed Original ResearchConceptsED visitsPolice transportCross-sectional studyEmergency departmentPhysical restraintBlack patientsBlack raceWhite patientsCross-sectional study of ED visitsIncreased oddsElectronic health record dataStudy of ED visitsHealth record dataEmergency carePoliceEthnic disparitiesVisit diagnosesMental healthMain OutcomesHigher oddsPatient restraintBehavioral crisesHispanic patientsBlack individualsRecord dataFellowship Accreditation: Experiences From Health Care Simulation Experts.
Musits A, Khan H, Cassara M, McKenna R, Penttila A, Ahmed R, Wong A. Fellowship Accreditation: Experiences From Health Care Simulation Experts. Journal Of Graduate Medical Education 2024, 16: 41-50. PMID: 38304604, PMCID: PMC10829926, DOI: 10.4300/jgme-d-23-00388.1.Peer-Reviewed Original ResearchConceptsSimulation leadersFellowship accreditationOne-on-one semistructured interviewsHealth care simulationImpact of accreditationProfessional societiesOpen coding techniqueThematic analysisWorkforce concernsQualitative studyStandardization of training programsTraining programSnowball samplingSimulation expertsFellowship programsAccreditation pathwaysLack of consensusAccreditation effortsSubthemesAccreditationPhenomenological frameworkParticipantsInterviewsSpectrum of opinionsFellowship
2023
A Qualitative Study of Racial, Ethnic, and Cultural Experiences of Minority Clinicians During Agitation Care in the Emergency Department
Agboola I, Rosenberg A, Robinson L, Brashear T, Eixenberger C, Shah D, Pavlo A, Im D, Ray J, Coupet E, Wong A. A Qualitative Study of Racial, Ethnic, and Cultural Experiences of Minority Clinicians During Agitation Care in the Emergency Department. Annals Of Emergency Medicine 2023, 83: 108-119. PMID: 37855791, PMCID: PMC10843036, DOI: 10.1016/j.annemergmed.2023.09.014.Peer-Reviewed Original ResearchConceptsEmergency departmentPatients of colorED cliniciansQuaternary care medical centerSemistructured individual interviewsMarginalized patient populationsManagement of agitationEthnic minority groupsEmergency careMinority patientsHealth careAgitation managementIndividual interviewsThematic analysisPrimary themesQualitative studyKey themesClinical interactionsOpen codingGroup discussionsMoral injuryCareMedical CenterAgitated patientsMinority groupsCharacterizing Racial Disparities in Emergency Department Pediatric Physical Restraint by Sex and Age
Tolliver D, Markowitz M, Obiakor K, Wong A, Cramer L, Robinson L, Nash K. Characterizing Racial Disparities in Emergency Department Pediatric Physical Restraint by Sex and Age. JAMA Pediatrics 2023, 177: 972-975. PMID: 37459087, PMCID: PMC10352924, DOI: 10.1001/jamapediatrics.2023.2300.Peer-Reviewed Original Research
2022
A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department
Wong AH, Sabounchi NS, Roncallo HR, Ray JM, Heckmann R. A qualitative system dynamics model for effects of workplace violence and clinician burnout on agitation management in the emergency department. BMC Health Services Research 2022, 22: 75. PMID: 35033071, PMCID: PMC8760708, DOI: 10.1186/s12913-022-07472-x.Peer-Reviewed Original ResearchConceptsExperience of workplace violenceClinician burnoutWorkplace violenceIncreased perceptions of safetyPhysical restraintPerceptions of safetyClinician stressWorkplace assaultsAgitated patientsEmergency departmentEffects of workplace violenceUse of restraintsQualitative system dynamics methodsModel building sessionsSymptoms of burnoutIncreased perceptionInterprofessional panelClinician stakeholdersResultsThe final modelRisk of assaultImpact future decisionsPatient safetyEpisodes of agitationAgitation managementClinician experience