Chief Resident, Department of Medicine, Yale School of Medicine and VA Connecticut Healthcare System.
Cardiology Fellow, Division of Cardiovascular Medicine, Penn Medicine.
MedEdPORTAL. 2023 Apr 18;19:11310. doi: 10.15766/mep_2374-8265.11310. eCollection 2023.
Quality improvement (QI) training is an essential component of resident medical education and a part of the ACGME core competencies. We present our residency's evidence-based QI curriculum, which outlines key components identified in the literature for successful QI education.
Our curriculum included a mandatory five-part longitudinal educational series during ambulatory education sessions for second-year residents. Modeled after the Institute for Healthcare Improvement model for improvement and taught by a chief resident, our curriculum introduced residents to key QI concepts through case-based, just-in-time didactics and applied experiential learning via concurrent resident-led longitudinal QI projects. Residents received structured, multilayer mentorship from a faculty mentor in their field of interest and the chief resident of quality and patient safety. Their work-in-progress projects were presented to faculty QI experts and institutional leadership for additional feedback and mentorship.
Since 2016, a total of 234 internal medicine residents have completed our QI curriculum and developed 67 QI projects, which have been presented at various local, regional, and national conferences. In the 2 most recent academic years, Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores significantly increased from 4.6 precurriculum to 6.3 postcurriculum ( < .001).
A longitudinal, experiential, and mentored QI curriculum teaches residents QI skill sets through incorporating mechanisms associated with successful educational initiatives and adult learning theory. Our QIKAT-R results and project output show that our curriculum is associated with improved trainee QI knowledge and systems-level improvements.
质量改进 (QI) 培训是住院医师医学教育的重要组成部分,也是 ACGME 核心能力的一部分。我们介绍了我们住院医师的循证 QI 课程,其中概述了文献中确定的成功 QI 教育的关键组成部分。
我们的课程包括为第二年住院医师在门诊教育会议期间提供强制性的五部分纵向教育系列。我们的课程借鉴了改善医疗保健研究所的改进模型,并由一名住院医师主任教授,通过基于案例的、及时的教学法向住院医师介绍关键的 QI 概念,并通过同时进行的住院医师主导的纵向 QI 项目进行应用体验式学习。住院医师从他们感兴趣的领域的教员导师和质量与患者安全主任那里获得结构化的、多层次的指导。他们的工作进展项目将提交给教员 QI 专家和机构领导层,以获得额外的反馈和指导。
自 2016 年以来,共有 234 名内科住院医师完成了我们的 QI 课程,并开发了 67 个 QI 项目,这些项目已在各种本地、区域和国家会议上展示。在最近的两个学术年中,质量改进知识应用工具修订版 (QIKAT-R) 评分从课程前的 4.6 分显著增加到课程后的 6.3 分(<.001)。
一个纵向的、体验式的、有指导的 QI 课程通过结合与成功教育计划和成人学习理论相关的机制,向住院医师传授 QI 技能。我们的 QIKAT-R 结果和项目成果表明,我们的课程与住院医师 QI 知识和系统层面改进的提高有关。