Malhotra Neha R, Lee Young J, Millar Morgan M, Cartwright Patrick C, Smith Brigitte K
University of Utah, Department of Surgery, Division of Urology, Salt Lake City, UT.
University of Illinois at Chicago, College of Medicine, Salt Lake City, UT.
Urology. 2020 Nov;145:83-89. doi: 10.1016/j.urology.2020.06.075. Epub 2020 Jul 28.
To determine the quality improvement (QI) experiences of urology residents in the United States.
An Institutional Review Board approved national survey of Urology residents was administered in June 2019. The survey instrument sought to understand QI curricular methods and experiences of urology residents as well as their knowledge of QI fundamentals.
Of 465 invited residents, 159 (34%) responded. Respondents represented all 8 AUA sections. The majority of respondents self-identified as white (66%). Females made up 30% of respondents. Less than 1/3 of residents (32%) report use of online modules, whereas nearly 2/3 (63%) report lecture-based didactics. Fifteen percent of residents report no QI curriculum. While nearly 2/3 of residents report receiving training in QI principles (64%), far less report receiving training in how to apply QI methodology (44%). Only 29% of residents report being required to lead a QI project. No differences were seen by training level. Only 3 respondents had heard of the Institute of Medicine's aims for quality improvement. Respondents had better knowledge of process, balancing and outcome measures, but less than half of respondents (49%) were able to correctly identify all 3. Having any QI curriculum is associated with correctly answering knowledge questions (P = .03).
From a resident perspective, urology residency programs currently provide QI curricula that are inadequate to ensure residents achieve Accreditation Council for Graduate Medical Education milestones. It is imperative the urology community as a whole address these curricular gaps to ensure graduates are prepared to deliver high-quality, cost-conscious care to their patients once in practice.
确定美国泌尿外科住院医师的质量改进（QI）经历。
2019年6月对泌尿外科住院医师进行了一项经机构审查委员会批准的全国性调查。该调查问卷旨在了解泌尿外科住院医师的QI课程方法和经历以及他们对QI基本原理的了解。
在465名受邀住院医师中，159名（34%）做出了回应。受访者代表了美国泌尿外科学会（AUA）的所有8个分会。大多数受访者自我认定为白人（66%）。女性占受访者的30%。不到三分之一的住院医师（32%）报告使用在线模块，而近三分之二（63%）报告采用基于讲座的教学方法。15%的住院医师报告没有QI课程。虽然近三分之二的住院医师报告接受了QI原则方面的培训（64%），但报告接受如何应用QI方法培训的比例要低得多（44%）。只有29%的住院医师报告被要求领导一个QI项目。不同培训水平之间未见差异。只有3名受访者听说过医学研究所的质量改进目标。受访者对过程、平衡和结果指标有更好的了解，但不到一半的受访者（49%）能够正确识别所有三项。有任何QI课程与正确回答知识问题相关（P = 0.03）。
从住院医师的角度来看，泌尿外科住院医师培训项目目前提供的QI课程不足以确保住院医师达到毕业后医学教育认证委员会的里程碑要求。整个泌尿外科界必须解决这些课程差距，以确保毕业生在实际工作中能够为患者提供高质量、注重成本的医疗服务。
