Kaiser Permanente, San Jose, CA, USA.
Alpert Medical School of Brown University, Providence, RI, USA.
Acad Psychiatry. 2020 Jun;44(3):267-271. doi: 10.1007/s40596-020-01184-2. Epub 2020 Jan 21.
The Accreditation Council for Graduate Medical Education (ACGME) mandates resident quality improvement (QI) training to improve patient safety, cost control, and efficiency. Thus, understanding this topic is crucial for early career physicians. This manuscript describes an enhanced, experiential QI curriculum for psychiatry residents and its outcomes.
Two cohorts of 12 third-year residents completed the curriculum, which included didactics, external resources, and expert guidance through small group project design, implementation, and analysis/presentation. A survey on resident confidence in QI principles and the quality improvement knowledge assessment tool-revised (QIKAT-R) was used before and after curriculum participation. Data were analyzed using parametric descriptive tests and repeated measures general linear models with Benjamini-Hochberg correction for multiple comparisons.
Resident confidence in performing seven of the ten steps of QI and QIKAT-R scores significantly improved for both cohorts (p = .011). Eighty-nine percent of residents felt that the curriculum met their goals.
The QI curriculum effectively improved resident QI confidence and knowledge. Residents reported that experiential engagement in the design, implementation, and analysis/presentation of their project was crucial to these achievements. This experiential QI curriculum with resident-generated QI projects addressed ACGME training requirements while integrating QI training directly into the residents' clinical activities, making the QI efforts relevant and meaningful while also achieving ACGME goals.
研究生医学教育认证委员会 (ACGME) 要求住院医师进行质量改进 (QI) 培训,以提高患者安全性、成本控制和效率。因此,了解这个主题对早期职业医生至关重要。本文描述了一种针对精神科住院医师的强化体验式 QI 课程及其成果。
两组 12 名三年级住院医师完成了课程,其中包括讲座、外部资源以及通过小组项目设计、实施和分析/演示提供的专家指导。在课程参与前后使用 QI 原则和质量改进知识评估工具修订版 (QIKAT-R) 的居民信心调查进行评估。使用参数描述性检验和重复测量一般线性模型进行数据分析,并使用 Benjamini-Hochberg 校正进行多重比较。
两个队列的住院医师在执行 QI 的十个步骤中的七个步骤的信心和 QIKAT-R 评分均显著提高(p=0.011)。89%的住院医师认为课程达到了他们的目标。
QI 课程有效提高了住院医师的 QI 信心和知识。住院医师报告说,在设计、实施和分析/演示自己项目方面的体验式参与对这些成就至关重要。这种具有住院医师生成的 QI 项目的体验式 QI 课程满足了 ACGME 的培训要求,同时将 QI 培训直接融入住院医师的临床活动中,使 QI 工作具有相关性和意义,同时实现了 ACGME 的目标。