McNab Duncan, McKay John, Bowie Paul
Medical Directorate, NHS Education for Scotland, Glasgow, UK
Medical Directorate, NHS Education for Scotland, Glasgow, UK.
Scott Med J. 2015 Nov;60(4):208-13. doi: 10.1177/0036933015606586. Epub 2015 Sep 27.
Small-scale quality improvement projects are expected to make a significant contribution towards improving the quality of healthcare. Enabling doctors-in-training to design and lead quality improvement projects is important preparation for independent practice. Participation is mandatory in speciality training curricula. However, provision of training and ongoing support in quality improvement methods and practice is variable. We aimed to design and deliver a quality improvement training package to core medical and general practice specialty trainees and evaluate impact in terms of project participation, completion and publication in a healthcare journal.
A quality improvement training package was developed and delivered to core medical trainees and general practice specialty trainees in the west of Scotland encompassing a 1-day workshop and mentoring during completion of a quality improvement project over 3 months. A mixed methods evaluation was undertaken and data collected via questionnaire surveys, knowledge assessment, and formative assessment of project proposals, completed quality improvement projects and publication success.
Twenty-three participants attended the training day with 20 submitting a project proposal (87%). Ten completed quality improvement projects (43%), eight were judged as satisfactory (35%), and four were submitted and accepted for journal publication (17%). Knowledge and confidence in aspects of quality improvement improved during the pilot, while early feedback on project proposals was valued (85.7%).
This small study reports modest success in training core medical trainees and general practice specialty trainees in quality improvement. Many gained knowledge of, confidence in and experience of quality improvement, while journal publication was shown to be possible. The development of educational resources to aid quality improvement project completion and mentoring support is necessary if expectations for quality improvement are to be realised.
小规模质量改进项目有望对提高医疗质量做出重大贡献。让实习医生设计并主导质量改进项目是其独立执业的重要准备。在专科培训课程中,参与此类项目是强制性的。然而,在质量改进方法及实践方面提供的培训和持续支持存在差异。我们旨在为核心医学及全科专科实习生设计并提供一个质量改进培训包,并从项目参与、完成情况以及在医疗期刊上发表的角度评估其影响。
开发了一个质量改进培训包,并提供给苏格兰西部的核心医学实习生和全科专科实习生,内容包括为期1天的研讨会以及在3个月内完成质量改进项目期间的指导。进行了混合方法评估,通过问卷调查、知识评估以及对项目提案、已完成的质量改进项目和发表成功情况的形成性评估来收集数据。
23名参与者参加了培训日,其中20人提交了项目提案(87%)。10人完成了质量改进项目(43%),8个项目被判定为令人满意(35%),4个项目被提交并被医疗期刊接受发表(17%)。在试点期间,参与者在质量改进方面的知识和信心有所提高,同时对项目提案的早期反馈很有价值(85.7%)。
这项小型研究报告称,在培训核心医学实习生和全科专科实习生进行质量改进方面取得了一定成功。许多人获得了质量改进的知识、信心和经验,同时表明在医疗期刊上发表是可行的。如果要实现质量改进的预期目标,就有必要开发教育资源以协助完成质量改进项目并提供指导支持。