Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
Centre for Quality Improvement and Patient Safety (C-QuIPS), Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Med Educ. 2021 Jan;55(1):72-81. doi: 10.1111/medu.14351. Epub 2020 Sep 27.
The explicit, intentional and systematic application of continuous quality improvement (QI) in medical education practice and research can improve medical education and help it achieve its goals. Quality improvement and medical education share a foundation centred on learning-experiencing, reflecting, thinking and acting in continuous cycles that spiral to sustained advancement. This suggests that a QI mindset can be brought to bear on various aspects of medical education research and practice.
To explore this possibility, we turn to W. Edwards Deming's System of Profound Knowledge, widely regarded as one of the foundational frameworks in quality improvement, where he argues strongly that there are four highly interrelated elements that are required for improvement: Appreciation of a System, Theory of Knowledge, Knowledge about Variation and Knowledge of Psychology. In this article, we define and explore each of the four domains and their application in medical education, highlighting both opportunities and challenges.
Medical educators who utilise QI in their educational practices can help create learning environments that imprint positively on learners and contribute to better outcomes in their clinical learning environments. We provide recommendations for how educators' informed use of QI can improve medical education and help it achieve its ultimate goal of improved health and health care.
在医学教育实践和研究中明确、有意和系统地应用持续质量改进（QI）可以改善医学教育，并帮助其实现目标。质量改进和医学教育有着共同的基础，以学习-体验为中心，在不断循环的反思、思考和行动中螺旋式上升，实现持续进步。这表明，QI 思维可以应用于医学教育研究和实践的各个方面。
为了探索这种可能性，我们转向 W.爱德华兹·戴明（W. Edwards Deming）的“深邃知识体系”，该体系被广泛认为是质量改进的基础框架之一，他强烈主张改进需要四个高度相关的要素：系统理解、知识理论、变异知识和心理学知识。在本文中，我们定义并探讨了这四个领域及其在医学教育中的应用，突出了机遇和挑战。
在教育实践中运用 QI 的医学教育者可以帮助创造积极影响学习者的学习环境，并为他们在临床学习环境中的更好成果做出贡献。我们提供了一些建议，说明教育者如何明智地运用 QI 可以改善医学教育，并帮助其实现改善健康和医疗保健的最终目标。
