Using an online quiz-based reinforcement system to teach healthcare quality and patient safety and care transitions at the University of California.

QUALITY ISSUE

Implementing quality improvement (QI) education during clinical training is challenging due to time constraints and inadequate faculty development in these areas.

INITIAL ASSESSMENT

Quiz-based reinforcement systems show promise in fostering active engagement, collaboration, healthy competition and real-time formative feedback, although further research on their effectiveness is required.

CHOICE OF SOLUTION

An online quiz-based reinforcement system to increase resident and faculty knowledge in QI, patient safety and care transitions.

IMPLEMENTATION

Experts in QI and educational assessment at the 5 University of California medical campuses developed a course comprised of 3 quizzes on Introduction to QI, Patient Safety and Care Transitions. Each quiz contained 20 questions and utilized an online educational quiz-based reinforcement system that leveraged spaced learning.

EVALUATION

Approximately 500 learners completed the course (completion rate 66-86%). Knowledge acquisition scores for all quizzes increased after completion: Introduction to QI (35-73%), Patient Safety (58-95%), and Care Transitions (66-90%). Learners reported that the quiz-based system was an effective teaching modality and preferred this type of education to classroom-based lectures. Suggestions for improvement included reducing frequency of presentation of questions and utilizing more questions that test learners on application of knowledge instead of knowledge acquisition.

LESSONS LEARNED

A multi-campus online quiz-based reinforcement system to train residents in QI, patient safety and care transitions was feasible, acceptable, and increased knowledge. The course may be best utilized to supplement classroom-based and experiential curricula, along with increased attention to optimizing frequency of presentation of questions and enhancing application skills.