Foong Theng Wai, Tiong Hui-Fen, Ong Say Yang, Chen Fun Gee
Department of Anaesthesia and Surgical Intensive Care, National University Hospital, Singapore, Singapore.
Med Teach. 2020 Nov;42(11):1228-1233. doi: 10.1080/0142159X.2020.1799960. Epub 2020 Aug 7.
In healthcare, quality improvement (QI) tools are predominantly used to address human, system and process factors to improve clinical care. We believe that QI tools can also be used to address similar factors in medical education, to facilitate improvement in learning outcomes and competencies for new junior doctors in a postgraduate medical education program in our anaesthesia and critical care unit.
A stepwise competency checklist was devised to guide the learning and monitor the percentage who had completed the required learning activities and tests at the end of each month. This was tabulated as monthly competency scores, and served as a measure of effectiveness of the education program. QI tools, namely the Fishbone diagram and Pareto chart, were used to identify modifiable root causes and prioritise interventions.
Monthly competency scores ranged 30-50% at baseline, and improved to 60-75% after 6 months, with the implementation of a series of QI interventions.
QI tools were utilised to guide education interventions, with consequent improvement in the monthly competency scores of our junior doctors. Focused improvement cycles that are aligned to learning outcomes are key to the success of using QI tools in medical education.
在医疗保健领域，质量改进（QI）工具主要用于解决人员、系统和流程因素，以改善临床护理。我们认为，QI工具也可用于解决医学教育中的类似因素，以促进我们麻醉与重症监护病房研究生医学教育项目中新入职初级医生学习成果和能力的提升。
设计了一份逐步能力检查表，以指导学习并监测每月底完成所需学习活动和测试的人员百分比。这被制成每月能力得分表格，并作为教育项目有效性的一种衡量标准。使用QI工具，即鱼骨图和帕累托图，来识别可修改的根本原因并确定干预措施的优先级。
基线时每月能力得分在30%-50%之间，在实施一系列QI干预措施6个月后提高到60%-75%。
使用QI工具指导教育干预措施，从而提高了我们初级医生的每月能力得分。与学习成果相一致的重点改进周期是在医学教育中成功使用QI工具的关键。
