Table 1. Characteristics of the included studies.

Study (First author)	Intervention(s), observation(s), or initiative(s)	Sample size	Outcome metric(s)	Selected result(s)	Conclusion(s)
Yadav [32]	Modified cardiovascular component of the Sequential Organ Failure Assessment	16,386 ICU admissions	ICU mortality; 28-day mortality	Improved prediction of ICU mortality (0.836 vs. 0.822, p < 0.001); improved prediction of in-hospital mortality (0.799 vs. 0.784, p < 0.001); improved prediction of 28-day mortality (0.798 vs. 0.783, p < 0.001)	Mortality for critically ill patients is better predicted with a modified cardiovascular component to the Sequential Organ Failure Assessment.
Davis [31]	Advanced Resuscitation Training (ART) program	556 cardiac arrests	Arrest incidence, survival-to-hospital discharge, arrest-related deaths, and in-hospital mortality	Decreased arrest incidence (2.7 to 1.2 per 1,000 patient discharges from non-ICU areas); improved survival-to-hospital discharge from 21 to 45% (p < 0.01); improved odds ratio for survival-to-discharge (OR 2.2 95% CI 1.4 to 3.4) and good neurological outcomes (OR 3.0 95% CI 1.7 to 5.3); decreased arrest-related deaths (2.1 to 0.5 per 1,000 patient discharge from non-ICU areas and 1.5 to 1.3 for ICU areas); decreased in-hospital mortality (2.2% to 1.8%)	Resuscitation training program can improve patient outcomes.
Ninan [33]	Didactic program	Not specified	Self-assessment survey of curriculum vitae resume knowledge, personal brand, interview skills, networking, negotiations, practice valuation, benefits analysis, med staff structure and governance, healthcare reform, and confidence in job-finding skills	Improvement in resident-perceived knowledge in all areas measured	Didactic programs can improve career development and leadership skills for anesthesiology residents.
Becker [30]	Daily bedside teaching, examinations, goal communication, topic recording, and “tip sheets”	193 survey responses (168 post-intervention)	Bedside teaching frequency, perceived time at bedside, rounding satisfaction, and rounding efficiency	Increased bedside teaching (10% to 61%); increased perceived time at bedside (37% to 59%); rounding satisfaction (6.7/10 to 7.4/10); no impact on rounding efficiency	Initiatives can improve education during rounds without sacrificing efficiency.
Nett [22]	Database search	10,510 intubations	Adverse events from intubation and procedural details	Desaturation is less common in international PICUs compared to North America (13% vs. 17%, p = 0.001); occurrence of adverse intubation events is lower for international PICUs compared to North America (11% vs 14%, p = 0.003); less cuffed endotracheal tubes (ETT) used internationally (52% vs. 95%, p < 0.001) and inversely correlated with rate of ETT exchange (p < 0.001)	Adverse intubation events are higher in North American PICUs compared to international PICUs.
Veenstra [21]	Advanced surgical airway curriculum	56 general surgery residents and 22 student nurse anesthetists	Test, checklist, and questionnaire. Scores ranged from 1 (would not allow to perform procedure independently) to 5 (would allow to perform procedure independently).	Needle cricothyroidotomy: 5/5 for surgical residents and 4.86 for student nurse anesthetists. Open cricothyroidotomy: ranges from 4.75 to 5 for surgical residents and 4.72 for SRNAs.	Simulation can teach the cognitive and procedural skills necessary to perform needle and open cricothyroidotomy.
Martinelli [23]	Creation of academic medicine rotation during anesthesiology intern year	10 anesthesiology interns	Survey (five-point Likert scale)	Improved confidence in plan–do–study–act (PDSA) cycles (2.5; 95% CI 2.1 to 2.9) and QI projects (2.4; 95% CI 1.9 to 2.9)	An academic medicine rotation improves resident confidence in the appraisal of literature, QI, professional development, and teaching.
Ferraro [24]	Resident chief of QI and patient safety (PS)	28 medicine interns and 49 medicine residents	Survey (six-point Likert scale ranging from medical student at 1, proficiency of clinical faculty at 4, and senior faculty scholar at 6)	Improved resident participation in QI and PS committees (1.5 to 2.7); improved ability to identify system errors (1.9 to 2.9 for residents)	Residency-appointed chief of QI and PS improves resident participation and education with ACGME CLER focus areas.
Galvagno [25]	Record review	1,008 patients	Compliance with quality assurance metrics	13% of patients with hypoxemia received no intervention.	QI assessment directs attention to deficient areas.
Raty [26]	Online modules, lectures, small group sessions	748 students	Course evaluations	The value of small group discussions, course quality, and effectiveness of resident teaching significantly improved (p < 0.05) with time of course and resident involvement.	Resident facilitators improve medical student course quality.
Shao [27]	Online curriculum, checklist, and simulation session	18 (16 physicians and two nurses)	Percentage of completed tasks	Tasks completed increased from 60.3% to 81.8% (p = 0.002).	Training improves physician confidence and simulated critical care scenario performance.
Foong [28]	Compulsory acute pain medicine rotation, summary of workflow, and digitalization of lectures	48 CA-1 residents	Monthly competency scores	Monthly competency scores increased following the implementation of each intervention from 33% to 57%; 60 to 75% and sustained at 75%, respectively.	Fishbone diagrams and Pareto charts can direct medical education improvements.
Shoultz [29]	20-question survey	151 providers (17 anesthesia residents or attendings)	Survey	2% use standardized tools to assess frailty; 37% believe that frailty affects all parts of patients’ health; 87% believe that frailty increases the chance of death.	There is a variable understanding of the definition of frailty and the rare use of standardized assessment tools, despite its perceived importance to patient outcomes.
Chu [3]	Weighted point system for equitable shift distribution	24 residents	Surveys	Reduced overall variance (2016: 63% ± 4.9%, p <0.01; 2017: 57% ± p <0.01)	Work distribution equity is achievable with a weighted point system.
Pimentel [4]	Posters, reminder cards, feedback, and simulation	1,122 events	Compliance	Nonrandom shift and trend: 68% (95% CI 65-72%) to 79% (95% CI 76-83%), p < 0.01	Interventions can lead to sustained increases in hand hygiene compliance.
Kristobak [5]	Problem-based learning discussion (PBLD)	10 attendings and 19 residents	Surveys (five-point Likert scale)	Residents reported the PBLD to be a valuable experience (3.9 ± 0.6).   Increased confidence to lead a QI initiative (3.7 ± 0.9). Increased likelihood to start personal QI initiative (3.1 ± 0.9).	PBLD is a feasible method for a QI curriculum.
Tamaki [6]	Formal teaching	168 residents	Pre- and post-intervention quizzes	34.2% improvement (2.7 points, p < 0.001)	Formal education improves tracheostomy knowledge.
Harrington [7]	SICU rotation	98 residents	Pre- and post-rotation surveys	Correlation between communication and experience providing end-of-life (EOL) care	Resident comfort with EOL communication and care is correlated with completion of SICU rotation.
Ziemba [8]	Simulation	289 residents	Pre- and post-simulation assessments	Ability to correctly identify factors required for a root cause analysis (RCA) (62% pre vs. 80% post, p = 0.02). Increase in the intent to ‘always report’ for each adverse event category (3% pre vs. 37% post, p < 0.001).	Simulation is an effective method to teach the components of RCA.
Scales [9]	Specialty-based team competition	422 residents	Percentage of questions attempted and engagement (response time)	Increased questions attempted (79% vs. 68%, p = 0.03) and faster response time (p = 0.006)	Team competition increases resident participation in an online course delivering QI content.
Tsai [10]	Simulation	177 participants	Pre- and post-simulation questionnaires	Improved self-rated team participation, confidence, and knowledge	Simulation can improve team dynamics within an emergency airway response team and individual confidence and knowledge.
Kuza [11]	Training session	42 trainees	Pre- and post-session examination and practical assessments	TTE-naïve mean score improvements with multiple choice questions: 28.2 ± 11.6; and with clinical assessments: 48.6 ± 23.4	A short didactic session on TTE can teach basic skills and encourage its use.
Ramsingh [12]	Online curriculum	686 exams	Diagnostic accuracy of portable point-of-care ultrasound (P-POCUS) compared to traditional assessments and formal diagnostic studies	Higher sensitivity for new diagnoses (p < 0.0001)	An online curriculum can help develop a P-POCUS service.
Flanagan [13]	Electronic tool	654 trainees	Pre- and post-intervention surveys; electronic data indicating problem list updating	Increased problem list updating (p = 0.002) and increased mean new problems added per day (64 pre vs 125 post, p <0.001)	Engagement of house staff in institutional goals is possible with electronic tools.
Cerfolio [14]	Lean and value stream mapping	42 cases	Turnover time	OR turnover time decreased from 37mins to 14mins (p <0.0001); estimated return on investment: $19,500/day	Non-valued steps in OR turnover can be identified with lean and value stream mapping.
Olson [15]	Badges	159 residents	Surveys	Decreased role misidentification (50.8% pre vs 10.2% post, p <0.001)   Less gender bias among female residents (65.2% pre vs 31.8% post, p <0.001)   Less misidentification from patients among underrepresented residents (84.6% pre vs 23.1% post, p = 0.008)	Role ID badges decrease role misidentification and gender bias.
Cattano [16]	Assessment form	8075 cases	Prediction of difficult airway	Improved predicted rates over time (p = 0.031)	Comprehensive airway assessments did not improve residents' ability to predict a difficult airway, but did improve over time.
Bryskin [17]	Sub-paraspinal block	10 patients	Opioid consumption; functional performance ability	Trend to decreased hydromorphone consumption (24hrs: 0.19 mg/kg vs 0.13 mg/kg, p = 0.72; 48hrs: 0.37 mg/kg vs 0.3 mg/kg, p = 0.37)   Improved functional performance ability (POD1: 6.7 vs 4.8, p = 0.0495; POD2: 8.9 vs 6.5, p = 0.04)	Sub-paraspinal block may be a reasonable component of multimodal analgesia.
Williams [18]	Assignment of cases to trainees the day before the patient clinic visit	504 visits	Wait time and session time	Mean wait time: 36.1min vs 21.4min, p <0.01; mean session time: 275.6min vs 247.5min, p <0.01	Case assignments the day prior to clinic visits improve efficiency.
Orebaugh [19]	Combined ultrasound/nerve stimulator blocks	9062 blocks	Incidence of nerve injury and local anesthetic systemic toxicity	Nerve injury 6-12 months: 3 vs 1, p = 0.003   Nerve injury >12 months: 1 vs 0, p = 0.24; seizure: 1 vs 0, p = 0.24	Nerve blocks are safe when performed by trainees with using ultrasound and nerve stimulator.
Epstein [10]	Evaluation by an anesthesia resident the day prior to scheduled inpatient procedure	24735 cases	Surgery cancellation	Most canceled cases were evaluated the day prior to surgery   Total canceled minutes: 67.6% (95% CI 64.4%-70.8%, p <10-6	More preoperative anesthesia visits are not an economically useful focus for the Perioperative Surgical Home.