Explanipedia

The Development of a Center for Innovation, Scholarship and Research (CISR): Building Sustainable Research Infrastructure to Support and Advance Undergraduate Medical Education Open

Nithya Attipetty, Amy E. Stickford-Becker, David Feldstein, Katy Rosko, Christine S. Seibert , et al. · 2025

Background: Medical education research supports the development and training of future health professionals. While innovative curricula are increasingly implemented in undergraduate medical education and evaluations and student outcomes ar…

Nursing Performance Using Clinical Prediction Rules for Acute Respiratory Infection Management: A Case-Based Simulation Open

Victoria L. Tiase, Patrice M. Hicks, Haddy Bah, A. Lynn Snow, David Mann , et al. · 2025

Overuse and misuse of antibiotics is an urgent health care problem and one of the key factors in antibiotic resistance. Validated clinical prediction rules have shown effectiveness in guiding providers to an appropriate diagnosis and ident…

Barriers and Enablers for Sustaining Nurse-Led Use of Clinical Decision Support Tools for Antibiotic Stewardship: A qualitative analysis (Preprint) Open

Victoria L. Tiase, Aurie Tovar, Natalie Henning, Mariana Braga, Kimberly E. McHugh , et al. · 2025

BACKGROUND Clinical decision support (CDS) tools embedded in electronic health records (EHRs) in the form of integrated clinical prediction rules (iCPRs) provide a potentially effective intervention to reduce inappropriate antibiotic pres…

Snowball Group Usability Testing for Rapid and Iterative Multisite Tool Development: Method Development Study Open

Katherine L Dauber-Decker, David Feldstein, Rachel Hess, David Mann, Eun Ji Kim , et al. · 2024

Background Usability testing is valuable for assessing a new tool or system’s usefulness and ease-of-use. Several established methods of usability testing exist, including think-aloud testing. Although usability testing has been shown to b…

Ambulatory antibiotic prescription rates for acute respiratory infection rebound two years after the start of the COVID-19 pandemic Open

Elizabeth R. Stevens, David Feldstein, Simon Jones, Chelsea Twan, Xingwei Cui , et al. · 2024

Background During the COVID-19 pandemic, acute respiratory infection (ARI) antibiotic prescribing in ambulatory care markedly decreased. It is unclear if antibiotic prescription rates will remain lowered. Methods We used trend analyses of …

Barriers to Implementing Registered Nurse–Driven Clinical Decision Support for Antibiotic Stewardship: Retrospective Case Study Open

Elizabeth R. Stevens, Lynn Xu, J. Kwon, Sumaiya Tasneem, Natalie Henning , et al. · 2024

Background Up to 50% of antibiotic prescriptions for upper respiratory infections (URIs) are inappropriate. Clinical decision support (CDS) systems to mitigate unnecessary antibiotic prescriptions have been implemented into electronic heal…

Barriers to Implementing Registered Nurse–Driven Clinical Decision Support for Antibiotic Stewardship: Retrospective Case Study (Preprint) Open

Elizabeth R. Stevens, Lynn Xu, J. Kwon, Sumaiya Tasneem, Natalie Henning , et al. · 2023

BACKGROUND Up to 50% of antibiotic prescriptions for upper respiratory infections (URIs) are inappropriate. Clinical decision support (CDS) systems to mitigate unnecessary antibiotic prescriptions have been implemented into electronic hea…

Reducing prescribing of antibiotics for acute respiratory infections using a frontline nurse-led EHR-Integrated clinical decision support tool: protocol for a stepped wedge randomized control trial Open

Elizabeth R. Stevens, Ruth Agbakoba, David Mann, Rachel Hess, Safiya Richardson , et al. · 2023

Disseminating child abuse clinical decision support among commercial electronic health records: Effects on clinical practice Open

David Feldstein, Isabel A. Barata, Thomas McGinn, Emily Heineman, Joshua Ross , et al. · 2023

Objectives The use of electronic health record (EHR)-embedded child abuse clinical decision support (CA-CDS) may help decrease morbidity from child maltreatment. We previously reported on the development of CA-CDS in Epic and Allscripts. T…

Clinician Attitudes and Beliefs Associated with More Aggressive Diagnostic Testing Open

Deborah Korenstein, Laura D. Scherer, Andrew Foy, Lisa Pineles, Alison D. Lydecker , et al. · 2022

Clinician Conceptualization of the Benefits of Treatments for Individual Patients Open

Daniel J. Morgan, Lisa Pineles, Jill Owczarzak, Larry Magder, Laura D. Scherer , et al. · 2021

In this survey study, clinicians significantly overestimated the benefits of treatment to individual patients. Clinicians with greater overestimates were more likely to report using treatments in actual patients.

Accuracy of Practitioner Estimates of Probability of Diagnosis Before and After Testing Open

Daniel J. Morgan, Lisa Pineles, Jill Owczarzak, Larry Magder, Laura D. Scherer , et al. · 2021

This survey study suggests that for common diseases and tests, practitioners overestimate the probability of disease before and after testing. Pretest probability was overestimated in all scenarios, whereas adjustment in probability after …

Dissemination of child abuse clinical decision support: Moving beyond a single electronic health record Open

Thomas McGinn, David Feldstein, Isabel A. Barata, Emily Heineman, Joshua Ross , et al. · 2020

Impact of Clinical Decision Support on Antibiotic Prescribing for Acute Respiratory Infections: a Cluster Randomized Implementation Trial Open

David Mann, Rachel Hess, Thomas McGinn, Safiya Richardson, Simon Jones , et al. · 2020

Using normalisation process theory to understand workflow implications of decision support implementation across diverse primary care settings Open

Rebecca G. Mishuris, Joseph Palmisano, Lauren McCullagh, Rachel Hess, David Feldstein , et al. · 2019

Background Effective implementation of technologies into clinical workflow is hampered by lack of integration into daily activities. Normalisation process theory (NPT) can be used to describe the kinds of ‘work’ necessary to implement and …

Live Usability Testing of Two Complex Clinical Decision Support Tools: Observational Study Open

Safiya Richardson, David Feldstein, Thomas McGinn, Linda Park, Sundas Khan , et al. · 2019

Live usability testing of these CDS tools generated insights about their role in the patient-provider interaction. CDS may contribute to the interaction by being simultaneously viewed by the provider and patient. CDS can improve usability …

Adaptive design of a clinical decision support tool: What the impact on utilization rates means for future CDS research Open

David Mann, Rachel Hess, Thomas McGinn, Rebecca G. Mishuris, Sara Chokshi , et al. · 2019

OBJECTIVE We employed an agile, user-centered approach to the design of a clinical decision support tool in our prior integrated clinical prediction rule study, which achieved high adoption rates. To understand if applying this user-center…

Live Usability Testing of Two Complex Clinical Decision Support Tools: Observational Study (Preprint) Open

Safiya Richardson, David Feldstein, Thomas McGinn, Linda Park, Sundas Khan , et al. · 2018

BACKGROUND Potential of the electronic health records (EHR) and clinical decision support (CDS) systems to improve the practice of medicine has been tempered by poor design and the resulting burden they place on providers. CDS is rarely t…

The Impact of a Primary Care Education Program Regarding Cancer Survivorship Care Plans: Results from an Engineering, Primary Care, and Oncology Collaborative for Survivorship Health Open

SarahMaria Donohue, James E. Haine, Zhanhai Li, Elizabeth Trowbridge, Sandra Kamnetz , et al. · 2017

“Think aloud” and “Near live” usability testing of two complex clinical decision support tools Open

Safiya Richardson, Rebecca G. Mishuris, Alexander O’Connell, David Feldstein, Rachel Hess , et al. · 2017

Design and implementation of electronic health record integrated clinical prediction rules (iCPR): a randomized trial in diverse primary care settings Open

David Feldstein, Rachel Hess, Thomas McGinn, Rebecca G. Mishuris, Lauren McCullagh , et al. · 2017

Successful Implementation of a Direct Observation Program in an Ambulatory Block Rotation Open

Jeremy Smith, Elizabeth Jacobs, Zhanhai Li, Bennett Vogelman, Yingqi Zhao , et al. · 2016

Background Direct observation of clinical skills is a cornerstone of competency-based education and training. Ensuring direct observation in a consistent fashion has been a significant challenge for residency programs. Objective The purpos…

Using educational prescriptions to teach medical students evidence-based medicine Open

Craig A. Umscheid, Matthew J. Maenner, Nikhil K. Mull, Angela F. Veesenmeyer, John T. Farrar , et al. · 2016

Purpose: To evaluate feasibility and impact of evidence-based medicine (EBM) educational prescriptions (EPs) in medical student clerkships. Methods: Students answered clinical questions during clerkships using EPs, which guid…

Using educational prescriptions to teach medical students evidence-based medicine Open

Craig A. Umscheid, Matthew J. Maenner, Nikhil K. Mull, Angela F. Veesenmeyer, John T. Farrar , et al. · 2016

Purpose: To evaluate feasibility and impact of evidence-based medicine (EBM) educational prescriptions (EPs) in medical student clerkships. Methods: Students answered clinical questions during clerkships using EPs, which guid…

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