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A Quality Improvement Curriculum for Internal Medicine Residents

2009; Association of American Medical Colleges; Linguagem: Inglês

10.15766/mep_2374-8265.7733

2374-8265

Darcy A. Reed, Christopher M. Wittich, Monica M. Drefahl, Furman S. McDonald,

Health Sciences Research and Education

OPEN ACCESSSeptember 23, 2009A Quality Improvement Curriculum for Internal Medicine Residents Darcy Reed, MD, MPH, Christopher Wittich, MD, PharmD, Monica Drefahl, MD, Furman McDonald, MD, MPH Darcy Reed, MD, MPH Mayo Medical School , Christopher Wittich, MD, PharmD Mayo Medical School , Monica Drefahl, MD Mayo Medical School , Furman McDonald, MD, MPH Mayo Medical School https://doi.org/10.15766/mep_2374-8265.7733 SectionsAbout ToolsDownload Citations ShareFacebookTwitterEmail Abstract Introduction: All residents graduating from ACGME-accredited programs must demonstrate competence in practice-based learning and improvement (PBLI) and systems-based practice (SBP). The principles and practice of quality improvement (QI) is a core component of these two competencies. We developed a 3-year, longitudinal QI curriculum to increase internal medicine residents' competency in PBLI and SBP, as well as to improve patient care through resident-led QI projects. To create the curriculum, we used an established, scholarly approach to curriculum development in medical education. We also developed multiple methods for learner assessment and curriculum evaluation. Methods: This resource includes a comprehensive users' guide with background and rationale, all materials needed to teach the curriculum including step-by-step guides to modules with hand-outs and references, learner assessment, curriculum evaluation information, and detailed instructions for faculty. The curriculum takes place over the 3 years of residency. During this time residents are exposed to modules that introduce the concepts of QI, and complete a QI project under faculty guidance. Results: Summative assessment of QI competency is performed using the QIPAT-7, a seven-item instrument used to numerically assess the quality of residents' written QI proposals. Each of the seven items is scored using an ordinal 5-point scale where 1 = Needs Improvement, 3 = Meets Expectations, and 5 = Exceeds Expectations. The 145 residents who have completed the curriculum have received a mean QIPAT-7 score of 3.31 (SD = 0.69). Discussion: We found that by identifying opportunities for residents to present and publish their QI projects, we achieved more enthusiastic resident participation in the curriculum. We also learned the importance of identifying an appropriate project mentor for residents and the importance of identifying qualified mentors at our institution (including those with formal QI credentials) and inviting them to mentor residents. We continue to work on developing mechanisms to link residents with appropriate mentors within our large institution. A third lesson we discovered is the benefit of aligning residents' QI projects with institutional priorities and initiatives. In our experience, it is easier to obtain institutional support for residents' QI initiatives when the focus of the project is related to important institutional activities. Educational Objectives By the end of this curriculum, learners will be able to: Identify a patient-centered problem in the health care system.Define and measure the magnitude of the problem.Consult with stakeholders.Conduct a root-cause analysis using established quality improvement (QI) tools.List and prioritize multiple interventions for addressing the problem.Select the best intervention using effort/yield analysis and stakeholder analysis.Identify an outcome that is directly related to the problem and can be measured.Determine an implementation timeline.Submit a written QI proposal.Select and meet with a faculty mentor for the project.Orally present a summary of the QI proposal in approximately 10 minutes. Sign up for the latest publications from MedEdPORTAL Add your email below FILES INCLUDEDReferencesRelatedDetails FILES INCLUDED Included in this publication: User's Guide.pdf Appendix A Module 1 Slides.ppt Appendix D Module 4 Slides.ppt Appendix F QIP Poster Template.ppt To view all publication components, extract (i.e., unzip) them from the downloaded .zip file. Download editor's noteThis publication may contain technology or a display format that is no longer in use. CitationReed D, Wittich C, Drefahl M, McDonald F. A Quality Improvement Curriculum for Internal Medicine Residents. MedEdPORTAL. 2009;5:7733. https://doi.org/10.15766/mep_2374-8265.7733 Copyright & Permissions© 2009 Reed et al. This is an open-access publication distributed under the terms of the Creative Commons Attribution-NonCommercial-Share Alike license.KeywordsInternship and ResidencyCompetency-Based EducationeHealth Disclosures None to report. Funding/Support None to report. tabs.loading