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. 2007 Sep;22(9):1330-4.
doi: 10.1007/s11606-007-0260-y. Epub 2007 Jun 30.

Validation of a method for assessing resident physicians' quality improvement proposals

James L Leenstra  1 , Thomas J Beckman, Darcy A Reed, William C Mundell, Kris G Thomas, Bryan J Krajicek, Stephen S Cha, Joseph C Kolars, Furman S McDonald
Affiliations

Validation of a method for assessing resident physicians' quality improvement proposals

James L Leenstra et al. J Gen Intern Med. 2007 Sep.

Abstract

Background: Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking.

Objective: We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability.

Design: QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised.

Participants: Seven raters used the instrument to assess 45 resident QI proposals.

Measurements: Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively.

Results: QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high.

Conclusions: This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

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Figure 1
Figure 1
Quality Improvement Proposal Assessment Tool (QIPAT-7). The scale is anchored to the bulleted comments on the left. To achieve a score of 3 or higher, all bullets for each domain must be met. The box sizes for each point of the scale are simply determined by the heading labels; that is, smaller boxes do not indicate smaller intervals between scale steps.
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