MedEdPORTAL (Jan 2007)
A Continuous Quality Improvement (CQI) Curriculum for Residents
Abstract
Abstract Introduction Continuous quality improvement (CQI) has become an ever-increasingly important part of the healthcare industry, both in terms of its effect on improving the care of patients, as well as on improving the educational environment. Resident participation in CQI is a relatively new activity, but potential benefits include the opportunity to be integrally involved in improving patient care and to have a sense of ownership in their own education. Methods This curriculum introduces CQI to residents as a module during an ambulatory rotation. During the month-long rotation, students attend a 1-hour didactic lecture followed by a 1-hour working session for a required quality improvement (QI) project, and then meet for a third discussion session. All students complete pre-/posttests to measure the achievement of the learning objectives. Results The effectiveness of outcomes for resident knowledge, skills, and attitudes during a pilot of the curriculum was described in a previous paper. A significant difference in pre- and posttest perceived knowledge and self-efficacy was shown. In addition, we have informally looked at all of the written projects and what eventually became of them. Approximately 60% of the projects have been either implemented or are in the planning phases for implementation. Discussion Unlike other curricula, which teach QI during electives, we feel that this material should be required given the fact that, according to the ACGME, this is a topic for which all residents must achieve competence. Following the principles of QI taught therein, it is important to continually strive to improve the curriculum by making changes based on resident feedback (e.g., residents prefer to receive feedback on project ideas via email). In order for students to successfully implement their projects prior to graduation we recommend: (1) introducing QI concepts during PGY2, rather than PGY3, (2) encouraging learners to choose quick win projects rather than grandiose changes; (3) having a QI champion and faculty mentorship for each resident. This required curriculum enables residents to create meaningful QI projects that have a substantial impact on patient care or the residency program.
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