Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions

Affiliations

¹ J. Goldman is assistant professor, Department of Medicine, scientist, Centre for Quality Improvement and Patient Safety, and cross-appointed researcher, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0003-1589-4070.
² A. Kuper is associate professor, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
³ G.R. Baker is professor and program lead, Quality Improvement and Patient Safety, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴ B. Bulmer is vice president, Education, St. Michael's Hospital, Unity Health Toronto, and lecturer, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁵ M. Coffey is associate professor, Department of Paediatrics, University of Toronto, medical officer for patient safety, Hospital for Sick Children, Toronto, Ontario, Canada, and associate clinical director, Children's Hospitals Solutions for Patient Safety, Cincinnati, Ohio.
⁶ L. Jeffs is research and innovation lead scholar in residence and senior clinician scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, associate professor, Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, and affiliate scientist, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁷ C. Shea is program director and lecturer, Quality Improvement and Patient Safety, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁸ C. Whitehead is professor, Department of Family and Community Medicine, director and scientist, Wilson Centre for Research in Education, University Health Network, University of Toronto, and vice president of education, Women's College Hospital, Toronto, Ontario, Canada.
⁹ K.G. Shojania is professor and vice chair, Department of Medicine, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-9942-0130.
¹⁰ B. Wong is associate professor, Department of Medicine, University of Toronto, director, Centre for Quality Improvement and Patient Safety, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

PMID: 32079957
DOI: 10.1097/ACM.0000000000003203

Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions

Joanne Goldman et al. Acad Med. 2020 Nov.

. 2020 Nov;95(11):1745-1754.

doi: 10.1097/ACM.0000000000003203.

Authors

Affiliations

¹ J. Goldman is assistant professor, Department of Medicine, scientist, Centre for Quality Improvement and Patient Safety, and cross-appointed researcher, Wilson Centre for Research in Education, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0003-1589-4070.
² A. Kuper is associate professor, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
³ G.R. Baker is professor and program lead, Quality Improvement and Patient Safety, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁴ B. Bulmer is vice president, Education, St. Michael's Hospital, Unity Health Toronto, and lecturer, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁵ M. Coffey is associate professor, Department of Paediatrics, University of Toronto, medical officer for patient safety, Hospital for Sick Children, Toronto, Ontario, Canada, and associate clinical director, Children's Hospitals Solutions for Patient Safety, Cincinnati, Ohio.
⁶ L. Jeffs is research and innovation lead scholar in residence and senior clinician scientist, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, associate professor, Lawrence S. Bloomberg Faculty of Nursing, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, and affiliate scientist, Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada.
⁷ C. Shea is program director and lecturer, Quality Improvement and Patient Safety, Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
⁸ C. Whitehead is professor, Department of Family and Community Medicine, director and scientist, Wilson Centre for Research in Education, University Health Network, University of Toronto, and vice president of education, Women's College Hospital, Toronto, Ontario, Canada.
⁹ K.G. Shojania is professor and vice chair, Department of Medicine, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-9942-0130.
¹⁰ B. Wong is associate professor, Department of Medicine, University of Toronto, director, Centre for Quality Improvement and Patient Safety, Faculty of Medicine, University of Toronto, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

PMID: 32079957
DOI: 10.1097/ACM.0000000000003203

Abstract

Purpose: Project-based experiential learning is a defining element of quality improvement (QI) education despite ongoing challenges and uncertainties. The authors examined stakeholders' perceptions and experiences of QI project-based learning to increase understanding of factors that influence learning and project experiences.

Method: The authors used a case study approach to examine QI project-based learning in 3 advanced longitudinal QI programs, 2 at the University of Toronto and 1 at an academic tertiary-care hospital. From March 2016 to June 2017, they undertook 135 hours of education program observation and 58 interviews with learners, program directors, project coaches, and institutional leaders and reviewed relevant documents. They analyzed data using a conventional and directed data analysis approach.

Results: The findings provide insight into 5 key factors that influenced participants' project-based learning experiences and outcomes: (1) variable emphasis on learning versus project objectives and resulting benefits, tensions, and consequences; (2) challenges integrating the QI project into the curriculum timeline; (3) project coaching factors (e.g., ability, capacity, role clarity); (4) participants' differing access to resources and ability to direct a QI project given their professional roles; and (5) workplace environment influence on project success.

Conclusions: The findings contribute to an empirical basis toward more effective experiential learning in QI by identifying factors to target and optimize. Expanding conceptualizations of project-based learning for QI education beyond learner-initiated, time-bound projects, which are at the core of many QI educational initiatives, may be necessary to improve learning and project outcomes.

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References

1. Headrick LA, Richardson A, Priebe GP. Continuous improvement learning for residents. Pediatrics. 1998;1014, pt 2768–773
1. Varkey P, Reller MK, Smith A, Ponto J, Osborn M. An experiential interdisciplinary quality improvement education initiative. Am J Med Qual. 2006;21:317–322
1. Kool B, Wise MR, Peiris-John R, Sadler L, Mahony F, Wells S. Is the delivery of a quality improvement education programme in obstetrics and gynaecology for final year medical students feasible and still effective in a shortened time frame? BMC Med Educ. 2017;17:91
1. Wong BM, Etchells EE, Kuper A, Levinson W, Shojania KG. Teaching quality improvement and patient safety to trainees: A systematic review. Acad Med. 2010;85:1425–1439
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;22:956–963

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Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions

Affiliations

Experiential Learning in Project-Based Quality Improvement Education: Questioning Assumptions and Identifying Future Directions

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources