Kim Kain, Adhyaru Bhavin, Doyle Joyce, Bussey-Jones Jada, Jones Danielle, DiFrancesco Lorenzo, Fluker Shelly Ann, Gitomer Richard, Ilksoy Nurcan
Division of General Medicine, Emory University School of Medicine, Atlanta, GA, USA.
Division of General Medicine, Department of Medicine, Emory University School of Medicine, Grady Health System, Atlanta, GA, USA.
J Med Educ Curric Dev. 2025 Feb 13;12:23821205251320482. doi: 10.1177/23821205251320482. eCollection 2025 Jan-Dec.
Residency programs face increasing expectations to grow competency in system-based practice and quality improvement (QI) among trainees. Organizations like the American Board of Internal Medicine and the Accreditation Council for Graduate Medical Education have included QI knowledge in their recertification and accreditation requirements. We describe our experiences over a decade of sustaining a longitudinal experiential QI curriculum at a large Internal Medicine residency program.
Each resident participated in interactive seminars as well as a faculty-mentored, team-based QI project. Each project was formally evaluated at an end-of-year poster presentation.
One hundred thirty-six projects were completed between 2007 and 2016. A presurvey of 51 PGY-1 residents (59%) and a postsurvey of 50 PGY-2 and PGY-3 residents (46%) demonstrated increased comfort leading a QI project and improved knowledge of QI principles. We continue a modified version of the curriculum to accommodate the residency program's restructured ambulatory teaching experiences and the impacts of the COVID-19 pandemic.
Implementing a performance improvement curriculum based in a resident continuity clinic is feasible and affords several advantages. In applying QI methodologies, residents learn how to measure adherence with current evidence-based medicine guidelines and develop interventions to maintain positive momentum within the reality of busy clinical practice.
住院医师培训项目面临着越来越高的期望,即要提高学员在基于系统的实践和质量改进(QI)方面的能力。美国内科医学委员会和毕业后医学教育认证委员会等组织已将QI知识纳入其再认证和认证要求中。我们描述了在一个大型内科住院医师培训项目中维持一个纵向体验式QI课程超过十年的经验。
每位住院医师都参加了互动研讨会以及由教员指导的基于团队的QI项目。每个项目在年终海报展示时进行正式评估。
2007年至2016年期间共完成了136个项目。对51名PGY-1住院医师(59%)进行的预调查以及对50名PGY-2和PGY-3住院医师(46%)进行的后调查显示,主导QI项目的舒适度有所提高,对QI原则的了解也有所改善。我们继续采用该课程的修改版本,以适应住院医师培训项目重组后的门诊教学经验以及新冠疫情的影响。
在住院医师连续性诊所实施绩效改进课程是可行的,且有诸多优势。在应用QI方法时,住院医师学会了如何衡量对当前循证医学指南的遵循情况,并制定干预措施以在繁忙的临床实践中保持积极的态势。