Current Research
Past Research
The following is a list of completed research studies by the Mullan Institute. Expand on the title to read more details about the project, including a description, related products, and staff contact for questions.
Filter by Topic
Moral Injury Among Nurses
- Study Year: 2025
Overview: Moral injury has become a powerful category of analysis for healthcare professionals explaining the challenges faced in their work environment. Moral injury is defined as “psychological, biological, spiritual, behavioral, and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations” (Litz et al., 2009). It is one of the major causes of burnout, secondary trauma, compassion fatigue, and other negative effects of nursing. This concept of moral injury emphasizes system-level causes and solutions, and is distinct from the emphasis on individual resilience as a solution to the costs of caring
We conducted a qualitative study to understand nurses’ experiences of moral injury and the context surrounding them. Using a subset of hospital nurses’ stories, we produced an illustrated and audio storybook.
Related Products
- Audio Storybook: From our study, we selected 23 critical incidents (CIs) of moral injury from 17 different nurses. Nurses described being unable to fulfill their professional duty to advocate for patients, with stories demonstrating betrayal, corruption, conflict around end-of-life situations, and feeling expendable. Early-career stories often centered on department- or unit-level issues, whereas later career stories tended to acknowledge the larger forces of executive leaders and the U.S. healthcare system.
Behavioral Health Workforce
- Study Year: 2024
Overview: The Mullan Institute developed a national database on the MH/SUD workforce. Using novel data sources, this comprehensive national database identifies nearly 1.2 million behavioral health providers, including physicians, psychologists, counselors, therapists, and advanced practice providers. The goal of this database was to provide evidence-based support for policy-making and the appropriate targeting of resources.
Related Products
- Behavioral Health Workforce Tracker
- Shenk E, Luo Q, Erikson CE. Tracking 5-Year Trends in the Workforce Prescribing Psychotropics and Medications for Opioid Use Disorder: A Cross-Sectional Study. J Gen Intern Med. 2024.
- Luo Q, Erikson CE. Changes in Waivered Clinicians Prescribing Buprenorphine and Prescription Volume by Patient Limit. JAMA. 2023;329(20):1792–1794.
- Ziemann MP, Dent RB, Schenk ED, et al. Documenting a Decade of Exponential Growth in Employer Demand for Peer Support Providers. J Behav Health Serv Res. 2023;50: 413–424.
- Erikson C, Schenk E, Westergaard S, Salsberg ES. “New Behavioral Health Workforce Database Paints A Stark Picture“. Health Affairs Forefront. August 30, 2023.
- Erikson CE, Dent RB, Park YH, Luo Q. Historic Redlining and Contemporary Behavioral Health Workforce Disparities. JAMA Netw Open. 2022;5(4):e229494.
- Schoebel V, Erikson C, Salsberg E, Muñoz L. Characteristics of the Behavioral Health Nursing Workforce: A Secondary Analysis of the National Sample Survey of Registered Nurses. Washington, DC: Fitzhugh Mullan Institute for Health Workforce Equity, George Washington University; 2024.
- Vichare A, Luo Q, Erikson C. Provision of Mental and Behavioral Health Services by Primary Care Providers: The Role of Medicaid Payment Generosity. Washington, DC: Fitzhugh Mullan Institute for Health Workforce Equity, George Washington University; 2024.
- Herring J, Vichare Anushree, Westergaard S, Luo Q, Erikson C. Assessing the Relationship between Social Vulnerability Index and Behavioral Health Provider Supply. Washington, DC: Fitzhugh Mullan Institute for Health Workforce Equity, George Washington University; 2024.
Project Contact: Clese Erikson
Funder: Substance Abuse and Mental Health Services Administration (SAMHSA)
Advancing the Clinical Research Workforce
- Study Year: 2025
Overview: This was a Phase I qualitative study to better understand workforce challenges in clinical research and inform strategies to strengthen the field. The Mullan Institute co-developed a structured focus group guide with the Association of Clinical Research Professionals (ACRP) and the Partners Advancing the Clinical Research Workforce Consortium, and led the implementation of in-person and virtual focus groups.
Project Contact: Clese Erikson
Funder: Association of Clinical Research Professionals
Workforce Study of Hematology Physicians
- Study Year: 2023
Overview: This project analyzed trends affecting the U.S. hematology physician workforce, with a particular emphasis on identifying physicians practicing benign hematology. It examined specialty selection and career influences among hematology/oncology fellows, including how interest in a hematology-focused career evolves over time. The project also assessed the job market for newly trained hematologists and identified key factors expected to influence future workforce supply and demand.
Related Products:
- Masselink LE, Erikson CE, Connell NT, et al. Associations between Hematology/Oncology Fellows’ Training and Mentorship Experiences and Hematology-only Career Plans. Blood Adv. 2019;3(21):3278-3286.
- Butt A, Mankbadi M, Erikson C, et al. Bias Against International Medical Graduates in the Hematology/Oncology Fellowship Recruitment Process: Findings From a Nationwide Survey of Fellowship Program Directors. JCO Oncol Pract. 2022;18(12):783-787.
- Lee AI, Masselink LE, De Castro LM, et al. Burnout in US Hematologists and Oncologists: Impact of Compensation Models and Advanced Practice Provider Support. Blood Adv. 2023;7(13):3058-3068.
- Marshall AL, Masselink LE, Kouides PA, et al. Advanced Practice Providers in Hematology: Actionable Findings from National Paired APP and Physician Surveys. Blood Adv. 2024 Mar 12;8(5):1179-1189. doi: 10.1182/bloodadvances.2023011927. PMID: 38127271; PMCID: PMC10910059.
Project Contacts: Clese Erikson or Leah Masselink
Funder: American Society of Hematology
Optimizing the Use of Medical Assistants in Primary Care
- Study Year: 2025
Overview: There is growing evidence that medical assistants (MAs) can play an important role in supporting primary care practices’ transition to team-based care, often resulting in improved quality of care, access to care, and productivity, as well as improved job satisfaction and reduced burnout. Much of the research on MAs to date has focused on individual health systems, with few studies examining variation in the scope of practice of MAs across primary care settings, including hospital-based ambulatory care, community health centers, and small primary care practices. This study was built on a planning phase grant, awarded to the New York Alliance for Careers in Healthcare (NYACH), the healthcare industry partnership of the NYC Mayor’s Office of Talent and Workforce Development, to undergo a landscape analysis and inform the design of a potential research effort.
Related Products:
- Report: Medical Assistants in New York: Focus Group Findings
- Report: Survey Results: The Medical Assistant Role in Primary Care
- Report: Medical Assistant Training in New York: Landscape, Challenges, and Opportunities for Enhancement
- Report: Focus Group Findings: Nurse Perspectives on Medical Assistant Roles in New York
Project Contact: Clese Erikson
Funder: New York Health Foundation (NYHealth)
Disclaimer: The views presented here are those of the authors and not necessarily those of NYHealth or its directors, officers, and staff.
Assessing the Role of Federally Sponsored School-Based Health Centers in Access to Care and Outcomes for Medicaid Beneficiaries
- Study Year: 2025
As of 2022, approximately 39% of children in the U.S. were covered by Medicaid/CHIP, but many face transportation barriers and other challenges with seeking medical care. This study examined differences in health care access and service utilization between Medicaid/CHIP-enrolled children who receive care from providers in school settings and those who do not, and by beneficiary race/ethnicity and rurality.
Related Products:
Project Contact: Clese Erikson
Funder: Health Resources and Services Administration
Measuring the Impact of the Nurse Licensure Compact (NLC) on RN Mobility: Evidence from NLC 2.0
- Study Year: 2025
Demand for nurses is expected to slightly exceed supply in the United States over the next ten years. Many healthcare organizations face severe recruitment and retention challenges, and geographic distribution remains inequitable. One strategy that has grown in popularity is the use of the Nurse Licensure Compact (NLC), which reduces administrative obstacles in licensing if nurses wish to either move to another state or practice outside their primary state of residence in another NLC participating state.
This study builds on DePasquale and Strange’s work by examining more recent periods that allow us to study the “enhanced” NLC that began in 2018, and by using different data sources (the CPS and the NSSRN).
Related Products:
Project Contact: Patricia Pittman
Funder: Health Resources and Services Administration
Concierge and Direct Primary Care (DPC) Models Impact on the Primary Care Workforce for Underserved Communities in the Washington Metropolitan Area
- Study Year: 2025
In recent years, the primary care landscape in the United States has seen significant shifts due to the emergence of alternative practice models such as concierge medicine and Direct Primary Care (DPC). These models have attracted attention as potential solutions to the growing challenges in traditional primary care, including high administrative burdens, clinician burnout, and barriers to patient access. This project was among the first studies to examine the potential downstream effects of these models on the primary care workforce in underserved communities (e.g., workforce loss).
Related Products
Project Contact: Eric Luo
Funder: Health Resources and Services Administration
Comparing Primary Care Providers’ Medicaid and Commercial Patient Panels
- Study Year: 2025
The availability of primary care providers (PCPs) is a key factor affecting access to care for Medicaid enrollees. Prior analysis by the Mullan Institute suggests that in 2019, about 87% of PCPs participated in Medicaid in the U.S., but participation varied considerably across states and by PCP specialty. This study examined office visit panels of Medicaid-engaged PCPs using national-level claims data and compared them with their commercial patient office visit panels.
Related Products:
Project Contact: Mandar Bodas
Funder: Health Resources and Services Administration
Incorporating Equity Considerations into the Health Workforce Funding Process
- Study Year: 2024
Through the review of the California Department of Health Care Access and Information’s (HCAI) workforce programs and a national landscape assessment, this project developed recommendations for consideration by HCAI to modify their processes for selecting and funding individuals and organizations in ways that reflect and promote its stated equity goals:
- increase the racial and linguistic diversity of California’s healthcare workforce
- increase the number of providers in medically underserved areas
- increase providers serving Medi-Cal members
The Mullan Institute identified best practices for elevating diversity, equity, and inclusion (DEI) in workforce development programming policies and procedures.
Project contact: Edward Salsberg
Funder: California HealthCare Foundation