Re-thinking How We Teach Quality Improvement: Adding Meaning to an ACGME Requirement
Many residency programs have struggled to meaningfully meet the ACGME quality improvement (QI) requirements. Similarly, our residents were receiving limited QI education, and their longitudinal projects were ineffective.
Create an integrated didactic and experiential learning environment that equips residents to become leaders of QI.
Setting and Participants
Internal medicine (IM) residency program of 45 residents in a large community hospital.
This curriculum included eight content areas. Games, real-life application, and project celebrations cultivated engagement. Sessions occurred during residents’ 2-week outpatient rotations. Project development was standardized.
The QI Knowledge Application Tool-Revised (QIKAT-R) and separate surveys were used before and after the curriculum’s implementation to evaluate resident QI knowledge and confidence, respectively. We also tracked QI scholarship and faculty engagement. Mean QIKAT-R scores improved significantly from 7.0 (SD 2.9) at baseline to 16.6 (SD 4.7) post-curriculum (n = 37 pairs, p = 0.043). Residents’ adverse event reporting increased from 44% (19/43) at baseline to 90% (28/31) post-curriculum. Seven presentations were accepted for local, regional, and national conferences, compared with one presentation the preceding year.
A QI curriculum can be successfully integrated in a “4 + 2” program.
KEY WORDSquality improvement resident education X + Y curriculum assessment QIKAT faculty engagement adverse event reporting
We would like to acknowledge the assistance and support of our IM program director, Thomas Boes, MD. This project would not have been possible without his support and the generous curricula time he allotted us. Additionally, we acknowledge John Elliot, PhD, for his assistance with biostatistics.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they do not have a conflict of interest.
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