About

Anna Lees is a professor in the Learning Sciences and Human Development area at the University of Washington College of Education. She is the Ballmer Endowed Professor of Equity and Early Learning and has a background that includes beginning her career as an early childhood classroom teacher in rural northern Michigan. Her research focuses on the development of children and youth, early childhood education, land-based and Indigenous methodologies, qualitative research methods, and teacher education and research. She partners with schools and communities to support early childhood teacher education and is committed to developing and sustaining reciprocal relationships with Indigenous communities, engaging community leaders as co-teacher educators, and integrating Indigenous values and ways of knowing into early childhood settings and higher education. Her current research involves developing land and water-based learning environments and professional development models led by tribal nations and communities, as well as relationship-based site-embedded professional development models with tribal early learning programs. Her scholarship has been recognized by several academic journals and foundations, and she currently serves as editor of the Tribal College and University Research Journal.

Research topics

• Computer Science
• Psychology
• Medicine
• World Wide Web
• Social Science
• Sociology
• Political Science
• Nursing
• Mathematics
• Statistics
• Medical education
• Law

Selected publications

• At the extreme limits of L-DOPA therapy: probable dopamine dysregulation and psychiatric complications in Parkinson’s disease

  BMJ Neurology Open · 2026-01-01 · 1 citations

  articleOpen access

  Background: Dopamine dysregulation syndrome (DDS) is an uncommon but debilitating complication of Parkinson's disease (PD), characterised by a compulsive overuse of dopaminergic therapy. Most reported cases are male and involve daily oral levodopa (L-DOPA) intake between 2000 and 4000 mg. Methods: We describe a female with young-onset PD who progressively escalated oral L-DOPA intake to a peak of 10 000 mg/day prior to subthalamic nucleus deep brain stimulation (DBS). A structured psychiatric assessment was performed after DBS. Whole-exome sequencing was conducted to evaluate possible genetic susceptibility. Results: The patient developed compulsive medication use, impulse control disorders and gingival black pigmentation with near-total tooth loss. Classical hedonistic DDS features were absent. Following DBS, the L-DOPA dose stabilised at 1800 mg/day, but psychosis emerged, requiring hospitalisation. Genetic testing did not identify a pathogenic cause for early-onset PD; a rare missense variant of uncertain significance was detected without established clinical relevance. Discussion: This case represents the highest sustained oral L-DOPA dose reported in PD. Despite lacking several core DDS features, the pattern of compulsive use suggests dopaminergic dysregulation. This case highlights limitations in current DDS criteria and suggests that contextual features, such as motor disability, psychological reinforcement and individual vulnerability, should be integrated into future refinements.

  PublisherOA PDFDOI

• Sisyphus' Alert: The Uphill Struggle to Improve Venous Thromboembolism Prophylaxis Clinical Decision Support

  Applied Clinical Informatics · 2025-08-01

  articleOpen access

  Chemoprophylaxis reduces the risk of hospital-acquired venous thromboembolism (VTE), but is not reliably ordered. Our institution created a clinical decision support (CDS) interruptive alert to remind clinicians to order VTE chemoprophylaxis when it is missing for qualifying inpatients. Unfortunately, this alert has required repeated modifications to ensure accurate logic, and continues to generate negative feedback from users.This study aimed to describe multiple failures in the development and postdeployment optimization of this interruptive alert, and our lessons learned.This study analyzed the number of times this alert fired over 6 months of testing and 16 months of deployment, and changes in either the frequency of alert firing or the frequency of the alert being dismissed without orders placed with iterative changes in the alert logic. Feedback about this alert was compiled and classified into common themes.The initial alert fired an average of 11,154 times per week when tested silently, prompting significant refinements before release. The alert shown to users fired an average of 53.8 times per 1,000 patient days in the first 6 months of the study period. Despite postlaunch improvements, this rose to 61 alerts per 1,000 patient days in the final 6 months of the study. Modifications also did not cause a significant decrease in how frequently the alert was dismissed without further action being taken (88%). Review of narrative feedback and its classification highlights "wrong person" receiving the alert being by far the most prevalent cause for negative submitted user feedback (nearly 50%), despite efforts to develop logic that limits firing to the patient's primary team.Changes to this VTE alert were summarized as failures to meet the "five rights" of CDS. Alerts for high-priority safety issues require persistent feedback-driven improvement, particularly when there is poor performance or negative user experience.

  PublisherOA PDFDOI

• ATS Workshop 2024

  CERN Document Server (European Organization for Nuclear Research) · 2024-01-01

  other1st authorCorresponding

  <!--HTML-->The Mechanical and Engineering support section of the Cryogenics group (TE-CRG-ME) is heavily involved in the design, production, installation and commissioning of a wide range of cryogenic devices and systems for the experiments, accelerators and test facilities at CERN. To increase the efficiency of our work and improve the standardization to the norms, calculations and methods used for development, a Cryogenic Engineering Tool Kit has been developed. This presentation will review the main contents of the toolkit and the importance of these methods to TE CRG ME.

  Publisher

• Uses of Electronic Health Record Data to Measure the Clinical Learning Environment of Graduate Medical Education Trainees: A Systematic Review

  Academic Medicine · 2023 · 9 citations

  1st authorCorresponding
  • Medical education
  • Medicine
  • Psychology

  PURPOSE: This study systematically reviews the uses of electronic health record (EHR) data to measure graduate medical education (GME) trainee competencies. METHOD: In January 2022, the authors conducted a systematic review of original research in MEDLINE from database start to December 31, 2021. The authors searched for articles that used the EHR as their data source and in which the individual GME trainee was the unit of observation and/or unit of analysis. The database query was intentionally broad because an initial survey of pertinent articles identified no unifying Medical Subject Heading terms. Articles were coded and clustered by theme and Accreditation Council for Graduate Medical Education (ACGME) core competency. RESULTS: The database search yielded 3,540 articles, of which 86 met the study inclusion criteria. Articles clustered into 16 themes, the largest of which were trainee condition experience (17 articles), work patterns (16 articles), and continuity of care (12 articles). Five of the ACGME core competencies were represented (patient care and procedural skills, practice-based learning and improvement, systems-based practice, medical knowledge, and professionalism). In addition, 25 articles assessed the clinical learning environment. CONCLUSIONS: This review identified 86 articles that used EHR data to measure individual GME trainee competencies, spanning 16 themes and 6 competencies and revealing marked between-trainee variation. The authors propose a digital learning cycle framework that arranges sequentially the uses of EHR data within the cycle of clinical experiential learning central to GME. Three technical components necessary to unlock the potential of EHR data to improve GME are described: measures, attribution, and visualization. Partnerships between GME programs and informatics departments will be pivotal in realizing this opportunity.

  PublisherOA PDFDOI

• Writing Practices Associated With Electronic Progress Notes and the Preferences of Those Who Read Them: Descriptive Study (Preprint)

  2021

  Senior authorCorresponding
  • Computer Science
  • Computer Science
  • Political Science

  <sec> <title>BACKGROUND</title> Hospital progress notes can serve as an important communication tool. However, they are criticized for their length, preserved content, and for the time physicians spend writing them. </sec> <sec> <title>OBJECTIVE</title> We aimed to describe hospital progress note content, writing and reading practices, and the preferences of those who create and read them prior to the implementation of a new electronic health record system. </sec> <sec> <title>METHODS</title> Using a sample of hospital progress notes from 1000 randomly selected admissions, we measured note length, similarity of content in successive daily notes for the same patient, the time notes were signed and read, and who read them. We conducted focus group sessions with note writers, readers, and clinical leaders to understand their preferences. </sec> <sec> <title>RESULTS</title> We analyzed 4938 inpatient progress notes from 418 authors. The average length was 886 words, and most were in the Assessment &amp;amp; Plan note section. A total of 29% of notes (n=1432) were signed after 4 PM. Notes signed later in the day were read less often. Notes were highly similar from one day to the next, and 26% (23/88) had clinical risk associated with the preserved content. Note content of the highest value varied according to the reader’s professional role. </sec> <sec> <title>CONCLUSIONS</title> Progress note length varied widely. Notes were often signed late in the day when they were read less often and were highly similar to the note from the previous day. Measuring note length, signing time, when and by whom notes are read, and the amount and safety of preserved content will be useful metrics for measuring how the new electronic health record system is used, and can aid improvements. </sec>

  PublisherDOI

• Writing Practices Associated With Electronic Progress Notes and the Preferences of Those Who Read Them: Descriptive Study

  Journal of Medical Internet Research · 2021 · 10 citations

  Senior authorCorresponding
  • Computer Science
  • Sociology
  • Psychology

  BACKGROUND: Hospital progress notes can serve as an important communication tool. However, they are criticized for their length, preserved content, and for the time physicians spend writing them. OBJECTIVE: We aimed to describe hospital progress note content, writing and reading practices, and the preferences of those who create and read them prior to the implementation of a new electronic health record system. METHODS: Using a sample of hospital progress notes from 1000 randomly selected admissions, we measured note length, similarity of content in successive daily notes for the same patient, the time notes were signed and read, and who read them. We conducted focus group sessions with note writers, readers, and clinical leaders to understand their preferences. RESULTS: We analyzed 4938 inpatient progress notes from 418 authors. The average length was 886 words, and most were in the Assessment & Plan note section. A total of 29% of notes (n=1432) were signed after 4 PM. Notes signed later in the day were read less often. Notes were highly similar from one day to the next, and 26% (23/88) had clinical risk associated with the preserved content. Note content of the highest value varied according to the reader's professional role. CONCLUSIONS: Progress note length varied widely. Notes were often signed late in the day when they were read less often and were highly similar to the note from the previous day. Measuring note length, signing time, when and by whom notes are read, and the amount and safety of preserved content will be useful metrics for measuring how the new electronic health record system is used, and can aid improvements.

  PublisherOA PDFDOI

• 相対的オフタイム削減におけるOpicaponeオッズ比:BIPARK-IとIIの組合せデータからの事後解析【JST・京大機械翻訳】

  Journal of the Neurological Sciences · 2019-01-01

  article
  Publisher

• The analysis of C9orf72 repeat expansions in a large series of clinically and pathologically diagnosed cases with atypical parkinsonism (vol 36, 1221.e1, 2015)

  UCL Discovery (University College London) · 2015-04-01

  article
  Publisher

• Analysis of sprint swimming: the 50m freestyle

  2013-02-01 · 2 citations

  article1st authorCorresponding
  PublisherDOI

• SPG11 sequencing in worldwide populations of familial and sporadic spastic paraplegia patients reveals frequent mutations and the common association of parkinsonian features

  UCL Discovery (University College London) · 2013-06-01

  article
  Publisher

Frequent coauthors

• O. Rascol

  Université de Toulouse

  2 shared

• Xi Li

  University of Southern California

  2 shared

• G Stebbins

  Rush University Medical Center

  2 shared

• Jennifer M. Zech

  ICAP Global Health

  2 shared

• Allison Brusati

  University of Washington

  2 shared

• Werner Poewe

  Innsbruck Medical University

  2 shared

• Dominic Paviour

  St George’s University Hospitals NHS Foundation Trust

  2 shared

• Sue E. Leurgans

  Rush University Medical Center

  2 shared

Awards & honors

• American Association of Colleges for Teacher Education’s Jou…
• Journal of Early Childhood Teacher Education
• Spencer Foundation
• editor of the Tribal College and University Research Journal