Cheung Lawrence
Department of Medicine, University of Alberta, Edmonton, AB, Canada.
Adv Med Educ Pract. 2017 Dec 1;8:779-784. doi: 10.2147/AMEP.S150718. eCollection 2017.
Quality improvement (QI) is an essential component of medical practice. Medical students and residents must learn the skills to conduct clinical QI during their educational programs. Medical educators must create and implement a curriculum in QI to empower their students to develop this skill and knowledge. However, developing and implementing a QI curriculum may be challenging for some residency programs. Residency programs with a relatively short duration of training - for example, only 2 years - may be unable to implement an extensive QI curriculum without siphoning away time for other learning objectives. Small residency programs may lack faculty with expertise to teach this topic. Residency programs with only a few residents may find it difficult to evaluate the success of a QI curriculum using robust statistical analysis. These residency programs need a QI curriculum with several features. The curriculum must be deliverable in a short period of time. There must be tools to assess the residents' attainment of the curricular objectives. The curriculum must give the residents practical skills to develop their own QI initiatives. Finally, there must be simple methods to evaluate the curriculum's effectiveness. To address these goals, we developed the SAFE QI (QI curriculum which is short, assessed, functional, and effective) framework for the 2-year subspecialty respirology residency program at the University of Alberta. There are 2-3 entrants per year for a total of 4-6 residents. This framework helps medical educators overcome the challenges of implementing a QI curriculum into their educational programs. This article illustrates how this framework was used to develop and deliver an institution's own QI curriculum.
质量改进（QI）是医疗实践的重要组成部分。医学生和住院医师在其教育项目中必须学习开展临床质量改进的技能。医学教育工作者必须创建并实施质量改进课程，以使学生有能力培养这项技能和知识。然而，对于一些住院医师培训项目来说，开发和实施质量改进课程可能具有挑战性。培训时长相对较短的住院医师培训项目——例如，只有两年——可能无法在不占用其他学习目标时间的情况下实施广泛的质量改进课程。小型住院医师培训项目可能缺乏讲授该主题的专业教师。住院医师人数较少的培训项目可能会发现，使用强大的统计分析来评估质量改进课程的成功与否很困难。这些住院医师培训项目需要具有几个特点的质量改进课程。该课程必须能在短时间内完成。必须有工具来评估住院医师对课程目标的达成情况。该课程必须赋予住院医师开发自己的质量改进计划的实用技能。最后，必须有简单的方法来评估课程的有效性。为实现这些目标，我们为阿尔伯塔大学为期两年的呼吸病学专科住院医师培训项目开发了SAFE QI（简短、可评估、实用且有效的质量改进课程）框架。每年有2至3名学员入学，共有4至6名住院医师。这个框架有助于医学教育工作者克服在其教育项目中实施质量改进课程的挑战。本文阐述了如何使用这个框架来开发和提供一所机构自己的质量改进课程。
