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基于项目的质量改进教育中的体验式学习:质疑假设和确定未来方向。

Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions.

机构信息

J. Goldman is assistant professor, Department of Medicine, scientist, Centre for Quality Improvement and Patient Safety, and cross-appointed researcher, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0003-1589-4070.

A. Kuper is associate professor, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

出版信息

Acad Med. 2020 Nov;95(11):1745-1754. doi: 10.1097/ACM.0000000000003203.

Abstract

PURPOSE

Project-based experiential learning is a defining element of quality improvement (QI) education despite ongoing challenges and uncertainties. The authors examined stakeholders' perceptions and experiences of QI project-based learning to increase understanding of factors that influence learning and project experiences.

METHOD

The authors used a case study approach to examine QI project-based learning in 3 advanced longitudinal QI programs, 2 at the University of Toronto and 1 at an academic tertiary-care hospital. From March 2016 to June 2017, they undertook 135 hours of education program observation and 58 interviews with learners, program directors, project coaches, and institutional leaders and reviewed relevant documents. They analyzed data using a conventional and directed data analysis approach.

RESULTS

The findings provide insight into 5 key factors that influenced participants' project-based learning experiences and outcomes: (1) variable emphasis on learning versus project objectives and resulting benefits, tensions, and consequences; (2) challenges integrating the QI project into the curriculum timeline; (3) project coaching factors (e.g., ability, capacity, role clarity); (4) participants' differing access to resources and ability to direct a QI project given their professional roles; and (5) workplace environment influence on project success.

CONCLUSIONS

The findings contribute to an empirical basis toward more effective experiential learning in QI by identifying factors to target and optimize. Expanding conceptualizations of project-based learning for QI education beyond learner-initiated, time-bound projects, which are at the core of many QI educational initiatives, may be necessary to improve learning and project outcomes.

摘要

目的

尽管存在持续的挑战和不确定性,基于项目的体验式学习仍是质量改进(QI)教育的一个决定性要素。作者研究了利益相关者对基于 QI 项目的学习的看法和经验,以增加对影响学习和项目经验的因素的理解。

方法

作者采用案例研究方法,考察了多伦多大学的 2 个和学术性三级保健医院的 1 个 3 个高级纵向 QI 项目中的基于 QI 项目的学习。2016 年 3 月至 2017 年 6 月,作者进行了 135 小时的教育项目观察和 58 次学习者、项目主任、项目教练和机构领导的访谈,并审查了相关文件。他们使用常规和定向数据分析方法分析数据。

结果

研究结果提供了对 5 个关键因素的深入了解,这些因素影响了参与者基于项目的学习经验和成果:(1)学习与项目目标的重视程度不同,以及由此产生的利益、紧张和后果;(2)将 QI 项目整合到课程时间线上的挑战;(3)项目指导因素(如能力、能力、角色清晰度);(4)参与者在其专业角色下对资源的不同获取和指导 QI 项目的能力;以及(5)工作场所环境对项目成功的影响。

结论

这些发现通过确定目标和优化因素,为 QI 中的更有效的体验式学习提供了实证基础。将 QI 教育中基于项目的学习的概念扩大到不仅仅是学习者发起的、有时间限制的项目,可能是必要的,这些项目是许多 QI 教育计划的核心,以提高学习和项目成果。

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