Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;8(3):405-9.
doi: 10.4300/JGME-D-15-00371.1.

Integrating a Resident-Driven Longitudinal Quality Improvement Curriculum Within an Ambulatory Block Schedule

Aleksey Tentler, Mirela Feurdean, Steven Keller, Neil Kothari

Integrating a Resident-Driven Longitudinal Quality Improvement Curriculum Within an Ambulatory Block Schedule

Aleksey Tentler et al. J Grad Med Educ. 2016 Jul.

Abstract

Background: Quality improvement (QI) is essential in clinical practice, requiring effective teaching in residency. Barriers include lack of structure, mentorship, and time.

Objective: To develop a longitudinal QI curriculum for an internal medicine residency program with limited faculty resources and evaluate its effectiveness.

Methods: All medicine residents were provided with dedicated research time every 8 weeks during their ambulatory blocks. Groups of 3 to 5 residents across all postgraduate year levels were formed. Two faculty members and 1 chief resident advised all groups, meeting with each group every 8 weeks, with concrete expectations for each meeting. Residents were required to complete didactic modules from the Institute for Healthcare Improvement. Current residents and alumni were surveyed for feedback.

Results: Over 3 years, all eligible residents (92 residents per year in 2012-2014, 102 in 2014-2015) participated in the curriculum. Residents worked on 54 quality assessment and 18 QI projects, with 6 QI projects showing statistically significant indicator improvements. About 50 mentoring hours per year were contributed by 2 faculty advisors and a chief resident. No other staff or IT support was needed. A total of 69 posters/abstracts were produced, with 13 projects presented at national or regional conferences. Survey respondents found the program useful; most (75% residents, 63% alumni) reported it changed their practice, and 71% of alumni found it useful after residency.

Conclusions: Our longitudinal QI curriculum requires minimal faculty time and resulted in increased QI-related publications and measurable improvements in quality indicators. Alumni reported a positive effect on practice after graduation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors declare they have no competing interests.

Figures

Figure
Figure
Ambulatory Block Schedules Abbreviations: QA, quality assessment; QI, quality improvement.
See this image and copyright information in PMC

References

    1. Swing SR. The ACGME outcome project: retrospective and prospective. Med Teach. 2007. 29 7: 648– 654. - PubMed
    1. Accreditation Council for Graduate Medical Education. Program requirements for graduate medical education in internal medicine. https://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CP.... Accessed March 1, 2016.
    1. Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd ed. San Francisco, CA: Jossey-Bass Publishers; 2009.
    1. Runnacles J, Moult B, Lachman P. Developing future clinical leaders for quality improvement: experience from a London children's hospital. BMJ Qual Saf. 2013; 22 11: 956– 963. - PubMed
    1. Patow CA, Karapovich K, Riesenberg LA, Jaeger J, Rosenfield JC, Wittenbreer M, et al. Residents' engagement in quality improvement: a systematic review of the literature. Acad Med. 2009; 84 12: 1757– 1764. - PubMed

LinkOut - more resources