Bailey Katherine, Farahani Elina, Raval Sunny, Lin Ke Xin, Nasser Muhammadhasan, Hersh Jonathan, Khan Farah, Chugh Shaan, Sharfuddin Nazia
Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
BMJ Open Qual. 2025 Jul 31;14(3):e003378. doi: 10.1136/bmjoq-2025-003378.
Quality improvement and patient safety (QIPS) is a core competency in undergraduate medical education. While didactic and experiential learning enhance QIPS knowledge and skills, there are limited experiential opportunities. This study aims to evaluate the feasibility and effectiveness of a longitudinal didactic and experiential student-led programme, Quality Improvement Experiential Student Training (QuEST). QuEST was piloted during year 1, where learners completed online modules, didactic seminars, an experiential project and mentorship meetings with the programme's faculty chair (Plan-Do-Study-Act [PDSA] 1). We implemented a formal leadership structure, adapted the curriculum, and changed mentorship meetings to student-led in year 2 (PDSA 2). In response to reduced learner satisfaction, we reintroduced faculty-led mentorship meetings in year 3 as well as revised the experiential project screening process and decreased the cohort size to enhance programme operations. The outcome was self-reported confidence in completing a QIPS project, which we aimed to achieve at least 60% of learners reporting confidence each year. Fourteen learners were enrolled in year 1, 45 in year 2 and 18 in year 3. After year 1, 86% of learners reported confidence in completing a QIPS project (from 39% preprogramme; p<0.01), 64% in year 2 (from 16%; p<0.01) and 75% in year 3 (from 28%; p<0.01). Programme satisfaction was 4.25/5 in year 1, 4.27/5 in year 2 and 4.75/5 in year 3. Strengths included experiential learning and support from the programme. Opportunities for improvement included further check-in meetings to promote accountability and project progression. The QuEST programme equipped learners with the confidence needed to complete a QIPS project. The provision of mentorship was identified as a common driver for learner satisfaction, with the suggestion to provide further structured and unstructured mentorship opportunities embedded in the programme. Future work may consider longitudinally assessing changes to learner behaviour.
质量改进与患者安全（QIPS）是本科医学教育的一项核心能力。虽然理论教学和实践学习能增强QIPS知识与技能，但实践机会有限。本研究旨在评估一项由学生主导的纵向理论与实践项目——质量改进实践学生培训（QuEST）的可行性和有效性。QuEST在第1年进行试点，学习者完成在线模块、理论研讨会、一个实践项目以及与该项目的教师主席进行指导会议（计划-执行-研究-行动[PDSA]1）。我们在第2年实施了正式的领导结构，调整了课程，并将指导会议改为由学生主导（PDSA 2）。由于学习者满意度降低，我们在第3年重新引入了由教师主导的指导会议，修订了实践项目筛选流程，并缩小了 cohort规模以优化项目运作。结果是自我报告的完成QIPS项目的信心，我们的目标是每年至少60%的学习者报告有信心。第1年有14名学习者入学，第2年有45名，第3年有18名。第1年后，86%的学习者报告有信心完成QIPS项目（项目前为39%；p<0.01），第2年为64%（从16%；p<0.01），第3年为75%（从28%；p<0.01）。项目满意度第1年为4.25/5，第2年为4.27/5，第3年为4.75/5。优点包括实践学习和项目支持。改进机会包括进一步的跟进会议以促进问责制和项目进展。QuEST项目使学习者具备了完成QIPS项目所需的信心。提供指导被认为是学习者满意度的一个共同驱动因素，并建议在项目中提供更多结构化和非结构化的指导机会。未来的工作可以考虑纵向评估学习者行为上的变化。
