A Novel Curricular Approach to Teach Quality Improvement and Health Disparities in a Family Medicine Clerkship

Abstract

Background and objectives: Medical schools must integrate educational curricula that teach how to apply quality improvement principles to improve care for vulnerable populations. In this report, we describe the development, implementation, and evaluation of a combined quality improvement (QI) and health disparities curriculum for third-year family medicine clerkship students.

Methods: After conducting an educational needs assessment, we developed a health disparities curriculum focused on QI principles for the family medicine clerkship. From November 2019 through August 2021, third-year medical students (N=395) completed the curriculum. The curriculum was delivered in an asynchronous online format, followed by a small group collaboration project to design and present a QI intervention through process mapping. Students also completed an individual reflection assignment that focused on care for vulnerable populations. Pre- and post assessment questions were administered on Qualtrics, after review by the clerkship director, research faculty and staff, and content experts for content and item validity. We analyzed quantitative data using SPSS version 27 software and used paired t tests for pre/post comparisons.

Results: In total, 392 students completed the preassessment survey, 395 students completed the postassessment surveys, and 341 had matching study identifiers. Pre-to-post assessment survey evaluations showed statistically significant changes for nine out of nine QI knowledge questions (P<.001), knowledge regarding a community health needs assessment (P<.001), and knowledge about caring for vulnerable populations (homeless, veterans, immigrants/refugees; P<.001).

Conclusions: Preliminary evaluation of a combined QI and health disparities curriculum shows improvement in students' self-reported knowledge of use of a community health needs assessment, QI principles, and care for vulnerable populations.

Figure 1

Sample Quality Improvement Process Map This process map focuses on improving transportation access for elderly/disabled patients. Customized Community Transportation (CCT) is a shared ride program for individuals over 65 years or who have disabilities.