L. Dumenco is assistant dean for medical education, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. K. Monteiro is director, Assessment and Evaluation, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. P. George is associate dean for medical education and director, Clinical Curriculum, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. S. Rougas is director, Doctoring Program, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. R. Dollase is professor emeritus of medical education, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Acad Med. 2019 Dec;94(12):1980-1987. doi: 10.1097/ACM.0000000000002898.
To evaluate whether quality improvement (QI) and patient safety (PS) training in preclerkship medical education resulted in students' development and retention of knowledge, application-based and perceived skills, and attitudes throughout clerkships.
A longitudinal QI/PS curriculum with multimodal curricular components was implemented in the preclerkship curriculum between 2015 and 2017 at the Warren Alpert Medical School of Brown University, Rhode Island. Assessments were administered at baseline (T1), end of year 1 (T2), Clinical Skills Clerkship (T3), and end of clerkships (T4) in the intervention cohort (n = 97). In 2018, T4 data for this cohort were compared with a prior control cohort (n = 97) at T4.
Results of knowledge-based multiple-choice questions (MCQs) (t[134] = -1.57, P < .001) and application-based skills (t[132] = -8.91, P < .001) demonstrated significant improvement from T1 to T2 (intervention cohort). Assessments of perceived skills showed significant growth from T1 to T2 (t[137] = -23.38, P < .001). Performance on application-based skills significantly improved from T2 to T3 (t[123] = -4.11, P < .001). Compared with the control cohort, the intervention cohort had significantly higher scores on MCQs (t[187.88] = 3.98, P < .001), application-based skills (t[72.69] = 6.40, P < .001), perceived skills (t[106.99] = 5.24, P < .001), and attitudes (t[152] = 5.86, P < .001).
Incorporation of preclerkship QI/PS training resulted in improvements in knowledge, application-based and perceived skills, and attitudes that were retained throughout clerkships.
评估在医学预科教育中进行质量改进（QI）和患者安全（PS）培训是否导致学生在整个实习期间发展和保留知识、基于应用的和感知技能以及态度。
2015 年至 2017 年，在罗德岛州布朗大学沃伦阿尔珀特医学院的医学预科课程中实施了具有多种课程组成部分的纵向 QI/PS 课程。在干预组（n=97）中，在基线（T1）、第 1 年结束时（T2）、临床技能实习（T3）和实习结束时（T4）进行评估。2018 年，将该队列的 T4 数据与之前的对照组（n=97）的 T4 数据进行比较。
基于知识的多项选择题（MCQ）（t[134]=-1.57，P<.001）和基于应用的技能（t[132]=-8.91，P<.001）的结果表明，从 T1 到 T2（干预组）有显著提高。感知技能评估显示，从 T1 到 T2 有显著增长（t[137]=-23.38，P<.001）。从 T2 到 T3，基于应用的技能显著提高（t[123]=-4.11，P<.001）。与对照组相比，干预组在 MCQ（t[187.88]=3.98，P<.001）、基于应用的技能（t[72.69]=6.40，P<.001）、感知技能（t[106.99]=5.24，P<.001）和态度（t[152]=5.86，P<.001）方面的得分显著更高。
在医学预科教育中纳入 QI/PS 培训导致知识、基于应用的和感知技能以及态度的提高，这些提高在实习期间得以保留。
