Tudiver Fred, Click Ivy A, Ward Patricia, Basden Jeri Ann
Department of Family Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, TN 37614. 423-439- 6728, USA.
Fam Med. 2013 Jan;45(1):19-25.
East Tennessee State University's (ETSU) Department of Family Medicine initiated Quality Improvement (QI) training in its three residency programs in 2008. The purpose of the project was to develop, implement, and assess a formal curriculum and experiential learning process to train family medicine residents in QI knowledge and skills.
Family medicine faculty members received training in QI theory and design. Rising second-year residents received a day-long workshop on the basics of QI principles. Residents worked in teams to develop and implement QI projects. Self-assessed QI proficiency was measured prior to and immediately following the workshop. QI knowledge was assessed with the Quality Improvement Knowledge Application Tool (QIKAT) at baseline and following project completion.
Two groups of residents (n=37) received training and completed at least 1 year on their projects. Analyses revealed that residents' self-assessed QI proficiency improved after receiving a day-long training workshop and was consistent for both groups of resident training. Application of QI knowledge as assessed by the QIKAT did not improve following QI project participation in resident Group 1 but did improve in resident Group 2.
A formal QI curriculum was successfully developed and implemented into three family medicine residency programs. Residents' QI knowledge and skills improved following training and experience conducting QI projects. Faculty and resident commitment to the program and competing time demands proved challenging to the introduction of QI training. Future studies should assess residents' sustained learning and translating QI residency experiences into practice.
东田纳西州立大学（ETSU）家庭医学系于2008年在其三个住院医师培训项目中启动了质量改进（QI）培训。该项目的目的是开发、实施并评估一个正式的课程和体验式学习过程，以培训家庭医学住院医师的QI知识和技能。
家庭医学教员接受了QI理论与设计方面的培训。即将升入二年级的住院医师参加了为期一天的QI原则基础知识研讨会。住院医师以团队形式开展并实施QI项目。在研讨会之前和之后立即测量自我评估的QI熟练程度。在基线时以及项目完成后，使用质量改进知识应用工具（QIKAT）评估QI知识。
两组住院医师（n = 37）接受了培训并在其项目上至少完成了1年。分析显示，住院医师在参加为期一天的培训研讨会后，自我评估的QI熟练程度有所提高，并且两组住院医师培训的结果一致。通过QIKAT评估的QI知识应用在第1组住院医师参与QI项目后没有提高，但在第2组住院医师中有所提高。
成功开发了一个正式的QI课程并将其应用于三个家庭医学住院医师培训项目。住院医师在接受培训以及开展QI项目的经验后，其QI知识和技能得到了提高。教员和住院医师对该项目的投入以及时间需求的竞争对QI培训的引入构成了挑战。未来的研究应评估住院医师的持续学习情况以及将QI住院医师培训经验转化为实践的情况。
