Kambria H. Evans, M.Ed., M.A., is the Director of Education and Quality Improvement at Stanford School of Medicine where she serves in the Practice of Medicine Course (two-year doctoring course), clerkship education, and graduate medical education. For over a decade, she has led innovative research across the medical training continuum in quality/safety and medical education through partnership with Stanford Graduate Medical Education, Stanford Geriatric Education Center, Stanford Faculty Development Center, Stanford Medicine Continuing Medical Education, Stanford Hospitalist Group, Stanford Internal Medicine Clinic, Stanford Scholarly Concentration Program, Stanford Hospice and Palliative Care Fellowship Program, VA Palo Alto Health Care System, Stanford Department of Pediatrics, Stanford Department of Surgery, and Stanford Department of Emergency Medicine.

At Stanford since 2004, she completed certification and professional development through the University of Texas System, Clinical Safety & Effectiveness Course. She received a grant from the Stanford Center for Continuing Medical Education for online gaming development in quality and safety, which will be disseminated to Stanford Hospital staff and a requirement for residents in all 90 residency programs through the Stanford Graduate Medical Education Department. She received two consecutive grants from the Stanford Vice Provost for Online Learning to collaborate on flipped classroom design for Stanford medical students. She also received the Division of General Research Award for Clinician-Educators to collaborate on best practices during transition to Stanford clerkships.

She received a B.S. and M.Ed. in Human and Organizational Development from Vanderbilt University, where she received the award for Outstanding Community Development and Social Policy. She received a M.A. in Psychology from California Institute of Integral studies.

Mrs. Evans is an expert in medical education, psychology, organizational improvement, and quality/safety. She leads quality/safety courses and develops curriculum for Stanford medical students, residents, fellows, and faculty to educate them about quality improvement methodology. She mentors them through quality improvement projects at Stanford Hospital and Clinics, Lucile Packard Children?s Hospital, and VA Palo Alto Health Care System to improve patient outcomes.

She highlights and disseminates this work in medical education and quality/safety as an invited speaker at national conferences, and internationally through publication in journals such as Academic Medicine, Academic Psychiatry, Journal of General Internal Medicine, Joint Commission Journal on Quality and Patient Safety, Journal of Hospital Medicine, American Journal of Medicine, Postgraduate Medical Journal, and PLOS ONE. Topics include blood transfusion practices, telemetry best practices and cost, online gaming for sepsis education, flipped classroom for quantitative medicine, impact of generational learners, medical students and electronic medical records, and discharge best practices.

Her research with Septris, a mobile-accessible, case-based, online game developed at Stanford, was piloted in 2012 with Stanford medical students and residents in Stanford Departments of Medicine, Surgery, and Emergency Medicine. By October 2014, Septris garnered over 61,000 visits worldwide in over 10 countries. After publication in Academic Medicine, this work was highlighted through an invited webinar with University HealthSystem Consortium. University of California Los Angeles Medical School, University College London Hospitals (United Kingdom), and University Medical Center of the Johannes Gutenberg University Mainz (Germany) collaborate with Stanford to utilize Septris at their institutions.

She is a reviewer for Academic Medicine, Journal of Hospital Medicine, and BMJ.

Honors & Awards

  • Award for Outstanding Community Development and Social Policy, Vanderbilt University (2004)
  • DGIM Research Award for Clinician-Educators with Dr. Basaviah, Stanford Medical School, Department of Medicine (2010)
  • VPOL grant with Dr. Popat, Stanford Vice Provost for Online Learning (2013)
  • VPOL grant with Drs. Posley, Popat, Stanford Vice Provost for Online Learning (2014)
  • CME grant with Drs. Katznelson, Shieh, Stanford Center for Continuing Medical Education (2015)

Education & Certifications

  • B.S., Vanderbilt University, Human and Organizational Development (2002)
  • M.Ed., Vanderbilt University, Organizational and Community Development (2004)
  • Alumni, The University of Texas System, Clinical Safety & Effectiveness Course (2014)
  • M.A., California Institute of Integral Studies, Psychology (2015)


All Publications

  • An Innovative Blended Preclinical Curriculum in Clinical Epidemiology and Biostatistics: Impact on Student Satisfaction and Performance Academic Medicine Evans, K. H., Thompson, A. C., O'Brien, C., Bryant, M., Basaviah, P., Prober, C., Popat, R. 2016
  • Hand hygiene of medical students and resident physicians: predictors of attitudes and behaviour BMJ Postgraduate Medical Journal Barroso, V., Caceres, W., Loftus, P., Evans, K., Shieh, L. 2016
  • Pending Studies at Hospital Discharge: A Pre-post Analysis of an Electronic Medical Record Tool to Improve Communication at Hospital Discharge JOURNAL OF GENERAL INTERNAL MEDICINE Kantor, M. A., Evans, K. H., Shieh, L. 2015; 30 (3): 312-318


    Achieving safe transitions of care at hospital discharge requires accurate and timely communication. Both the presence of and follow-up plan for diagnostic studies that are pending at hospital discharge are expected to be accurately conveyed during these transitions, but this remains a challenge.To determine the prevalence, characteristics, and communication of studies pending at hospital discharge before and after the implementation of an electronic medical record (EMR) tool that automatically generates a list of pending studies.Pre-post analysis.260 consecutive patients discharged from inpatient general medicine services from July to August 2013.Development of an EMR-based tool that automatically generates a list of studies pending at discharge.The main outcomes were prevalence and characteristics of pending studies and communication of studies pending at hospital discharge. We also surveyed internal medicine house staff on their attitudes about communication of pending studies.Pre-intervention, 70% of patients had at least one pending study at discharge, but only 18% of these were communicated in the discharge summary. Most studies were microbiology cultures (68%), laboratory studies (16%), or microbiology serologies (10%). The majority of study results were ultimately normal (83%), but 9% were newly abnormal. Post-intervention, communication of studies pending increased to 43% (p?

    View details for DOI 10.1007/s11606-014-3064-x

    View details for Web of Science ID 000350886500011

    View details for PubMedID 25416599

  • Septris: A Novel, Mobile, Online, Simulation Game That Improves Sepsis Recognition and Management ACADEMIC MEDICINE Evans, K. H., Dais, W., Tsui, J., Strehlow, M., Maggio, P., Shieh, L. 2015; 90 (2): 180-184


    Annually affecting over 18 million people worldwide, sepsis is common, deadly, and costly. Despite significant effort by the Surviving Sepsis Campaign and other initiatives, sepsis remains underrecognized and undertreated.Research indicates that educating providers may improve sepsis diagnosis and treatment; thus, the Stanford School of Medicine has developed a mobile-accessible, case-based, online game entitled Septris ( Septris, launched online worldwide in December 2011, takes an innovative approach to teaching early sepsis identification and evidence-based management. The free gaming platform leverages the massive expansion over the past decade of smartphones and the popularity of noneducational gaming.The authors sought to assess the game's dissemination and its impact on learners' sepsis-related knowledge, skills, and attitudes. In 2012, the authors trained Stanford pregraduate (clerkship) and postgraduate (resident) medical learners (n = 156) in sepsis diagnosis and evidence-based practices via 20 minutes of self-directed game play with Septris. The authors administered pre- and posttests.By October 2014, Septris garnered over 61,000 visits worldwide. After playing Septris, both pre- and postgraduate groups improved their knowledge on written testing in recognizing and managing sepsis (P < .001). Retrospective self-reporting on their ability to identify and manage sepsis also improved (P < .001). Over 85% of learners reported that they would or would maybe recommend Septris.Future evaluation of Septris should assess its effectiveness among different providers, resource settings, and cultures; generate information about how different learners make clinical decisions; and evaluate the correlation of game scores with sepsis knowledge.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

    View details for DOI 10.1097/ACM.0000000000000611

    View details for Web of Science ID 000348808000022

  • Why providers transfuse blood products outside recommended guidelines in spite of integrated electronic best practice alerts. Journal of hospital medicine Chen, J. H., Fang, D. Z., Tim Goodnough, L., Evans, K. H., Lee Porter, M., Shieh, L. 2015; 10 (1): 1-7


    Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines.To understand why providers order blood transfusions outside of recommended guidelines despite interruptive alerts.Retrospective review.Tertiary care hospital.Inpatient healthcare providers.Provider-BPA interaction data were collected from January 2011 to August 2012 from the hospital electronic medical record.Provider (free-text) responses to blood transfusion BPA prompts were independently reviewed and categorized by 2 licensed physicians, with agreement assessed by ?(2) analysis and kappa scoring.Rationale for overriding blood transfusion BPAs was highly diverse, acute bleeding being the most common (>34%), followed by protocolized behaviors on specialty services (up to 26%), to "symptomatic" anemia (11%-12%). Many providers transfused in anticipation of surgical or procedural intervention (10%-15%) or imminent hospital discharge (2%-5%). Resident physicians represented the majority (55%) of providers interacting with BPAs.Providers interacting with BPAs (primarily residents and midlevel providers) often do not have the negotiating power to change ordering behavior. Protocolized behaviors, unlikely to be influenced by BPAs, are among the most commonly cited reasons for transfusing outside of guidelines. Symptomatic anemia is a common, albeit subjective, indication cited for blood transfusion. With a wide swath of individually uncommon rationales for transfusion behavior, secondary use of electronic medical record databases and integrated CDS tools are important to efficiently analyze common practice behaviors. Journal of Hospital Medicine 2014. 2014 The Authors Journal of Hospital Medicine published by Wiley Periodicals, Inc. on behalf of Society of Hospital Medicine.

    View details for DOI 10.1002/jhm.2236

    View details for PubMedID 25044190

  • The Medical Education of Generation Y Academic Psychiatry Evans, K. H., Ozdalga, E., Ahuja, N. 2015
  • Hospitalist Intervention for Appropriate use of Telemetry Reduces Length of Stay and Cost Journal of Hospital Medicine Svec, D., Ahuja, N., Evans, K., Hom, J., Garg, T., Loftus, P., Shieh, L. 2015

    View details for DOI 10.1002/jhm.2411

  • Development and Evaluation of an Electronic Medical Record?Based Best-Practice Discharge Checklist for Hospital Patients The Joint Commission Journal on Quality and Patient Safety Garg, T., Lee, J., Evans, K. H., Chen, J., Shieh, L. 2015; 41 (3): 126-1
  • The Impact of a Faculty Development Program in Health Literacy and Ethnogeriatrics ACADEMIC MEDICINE Evans, K. H., Bereknyei, S., Yeo, G., Hikoyeda, N., Tzuang, M., Braddock, C. H. 2014; 89 (12): 1640-1644


    A faculty development curriculum aimed at increasing health literacy and awareness of patient care issues in ethnogeriatrics is essential to address serious deficiencies in faculty and health professionals' training and to prepare future health care professionals to care for older adults.Authors from the Stanford Geriatric Education Center developed and implemented a faculty development program in Health Literacy and Ethnogeriatrics (HLE). The goal was to enhance faculty and health professionals' knowledge, skills, and attitudes in HLE-related areas (e.g., health disparities, low health literacy, quality of care for ethnically diverse elders, patient/provider communication). The curriculum was implemented during an intensive weeklong program over a three-year period (2008-2010). The eight-module core curriculum was presented in a train-the-trainer format, supplemented by daily resource sessions.Thirty-four faculty participants from 11 disciplines, including medicine, came from 19 institutions in 12 states. The curriculum positively affected participants' knowledge, skills, and attitudes related to topics in HLE. Participants rated the curriculum's usefulness highly, and they reported that over 57% of the content was new. The HLE curriculum provided a mechanism to increase the self-assessed knowledge, skills, and attitudes of participants. It also fostered local curricular change: Over 91% of the participants have either disseminated the HLE curriculum through seminars conducted at their home sites or implemented HLE-related projects in their local communities, reaching diverse patient populations.Next steps include measuring the impact on the participants' teaching skills and at their home sites through their trainees and patients.

    View details for DOI 10.1097/ACM.0000000000000411

    View details for Web of Science ID 000345919500024

    View details for PubMedID 25006703

  • Medical students and the electronic health record: 'an epic use of time'. American journal of medicine Chi, J., Kugler, J., Chu, I. M., Loftus, P. D., Evans, K. H., Oskotsky, T., Basaviah, P., Braddock, C. H. 2014; 127 (9): 891-895

    View details for DOI 10.1016/j.amjmed.2014.05.027

    View details for PubMedID 24907594

  • Smarter Hospital Communication: Secure Smartphone Text Messaging Improves Provider Satisfaction and Perception of Efficacy, Workflow JOURNAL OF HOSPITAL MEDICINE Przybylo, J. A., Wang, A., Loftus, P., Evans, K. H., Chu, I., Shieh, L. 2014; 9 (9): 573-578


    Though current hospital paging systems are neither efficient (callbacks disrupt workflow), nor secure (pagers are not Health Insurance Portability and Accountability Act [HIPAA]-compliant), they are routinely used to communicate patient information. Smartphone-based text messaging is a potentially more convenient and efficient mobile alternative; however, commercial cellular networks are also not secure.To determine if augmenting one-way pagers with Medigram, a secure, HIPAA-compliant group messaging (HCGM) application for smartphones, could improve hospital team communication.Eight-week prospective, cluster-randomized, controlled trialStanford HospitalThree inpatient medicine teams used the HCGM application in addition to paging, while two inpatient medicine teams used paging only for intra-team communication.Baseline and post-study surveys were collected from 22 control and 41 HCGM team members.When compared with paging, HCGM was rated significantly (P?

    View details for DOI 10.1002/jhm.2228

    View details for Web of Science ID 000342679100004

    View details for PubMedID 25110991

  • New Ideas for Old News: What Impact Can Mobile Gaming Have on the Sepsis Epidemic? AM Rounds (Academic Medicine blog) Evans, K. H. 2014
  • Patient whiteboards to improve patient-centred care in the hospital. Postgraduate medical journal Tan, M., Hooper Evans, K., Braddock, C. H., Shieh, L. 2013; 89 (1056): 604-609


    Patient whiteboards facilitate communication between patients and hospital providers, but little is known about their impact on patient satisfaction and awareness. Our objectives were to: measure the impact in improving patients' understanding of and satisfaction with care; understand barriers for their use by physicians and how these could be overcome; and explore their impact on staff and patients' families.In 2012, we conducted a 3-week pilot of multidisciplinary whiteboard use with 104 inpatients on the general medicine service at Stanford University Medical Center. A brief, inperson survey was conducted with two groups: (1) 56 patients on two inpatient units with whiteboards and (2) 48 patients on two inpatient units without whiteboards. Questions included understanding of: physician name, goals of care, discharge date and satisfaction with care. We surveyed 25 internal medicine residents regarding challenges of whiteboard use, along with physical therapists, occupational therapists, case managers, consulting physicians and patients' family members (n=40).The use of whiteboards significantly increased the proportion of patients who knew: their physician (p?=0.0001), goals for admission (p?=0.0016), their estimated discharge date (p?=0.049) and improved satisfaction with the hospital stay overall (p?=0.0242). Physicians, ancillary staff and patient families all found the whiteboards to be helpful. In response, residents were also more likely to integrate whiteboard use into their daily work flow.Inpatient whiteboards help physicians and ancillary staff with communication, improve patients' awareness of their care team, admission plans and duration of admission, and significantly improve patient overall satisfaction.

    View details for DOI 10.1136/postgradmedj-2012-131296

    View details for PubMedID 23922397

  • Relationships of the Location and Content of Rounds to Specialty, Institution, Patient-Census, and Team Size PLOS ONE Priest, J. R., Bereknyei, S., Hooper, K., Braddock, C. H. 2010; 5 (6)


    Existing observational data describing rounds in teaching hospitals are 15 years old, predate duty-hour regulations, are limited to one institution, and do not include pediatrics. We sought to evaluate the effect of medical specialty, institution, patient-census, and team participants upon time at the bedside and education occurring on rounds.Between December of 2007 and October of 2008 we performed 51 observations at Lucile Packard Children's Hospital, Seattle Children's Hospital, Stanford University Hospital, and the University of Washington Medical Center of 35 attending physicians. We recorded minutes spent on rounds in three location and seven activity categories, members of the care team, and patient-census.Results presented are means. Pediatric rounds had more participants (8.2 vs. 4.1 physicians, p<.001; 11.9 vs. 2.4 non-physicians, p<.001) who spent more minutes in hallways (96.9 min vs. 35.2 min, p<.001), fewer minutes at the bedside (14.6 vs. 38.2 min, p = .01) than internal medicine rounds. Multivariate regression modeling revealed that minutes at the bedside per patient was negatively associated with pediatrics (-2.77 adjusted bedside minutes; 95% CI -4.61 to -0.93; p<.001) but positively associated with the number of non-physician participants (0.12 adjusted bedside minutes per non physician participant; 95% CI 0.07 to 0.17; p = <.001). Education minutes on rounds was positively associated with the presence of an attending physician (2.70 adjusted education minutes; 95% CI 1.27 to 4.12; p<.001) and with one institution (1.39 adjusted education minutes; 95% CI 0.26 to 2.53; p = .02).Pediatricians spent less time at the bedside on rounds than internal medicine physicians due to reasons other than patient-census or the number of participants in rounds. Compared to historical data, internal medicine rounds were spent more at the bedside engaged in patient care and communication, and less upon educational activities.

    View details for DOI 10.1371/journal.pone.0011246

    View details for Web of Science ID 000279058300029

    View details for PubMedID 20574534

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