Using QI Methodology to Improve a Program's QI Curriculum: An Educational Improvement Project

Abstract

Introduction: Quality improvement (QI) as a method of obtaining meaningful change is increasingly valued. A few comprehensive, longitudinal curricula demonstrate efficacy, patient impact, and behavior change over time. This educational improvement study aimed to create a curriculum that increased resident proficiency in practicing QI principles, score on the QI Knowledge Application Tool-Revised, and QI projects completing at least 2 plan-do-study-act (PDSA) cycles in 5 years. Methods: We utilized The Model for Improvement and sequential PDSA cycles, testing curricular components for improvement. Measures were analyzed annually (2014-2020). The curriculum includes modules and didactic workshops for foundational knowledge, rapid personal improvement projects for putting knowledge into practice, and experiential learning through developing and leading QI projects. Results: Graduating residents reporting proficiency in practicing QI principles increased from 4 (44%) to 11 (100%). The average QI Knowledge Application Tool-Revised score increased from 50% to 94% (95% CI, 37-51). Resident QI projects completing at least 2 PDSA cycles increased from 30% (n = 3) to 100% (n = 4), P = 0.0005, while projects achieving improvement increased from 40% (n = 4) to 100% (n = 3), P = 0.002. Patients were also positively impacted, with 63% (n = 3) of clinical QI projects that measured patient-centered outcomes achieving improvement and 69% (n = 11) of clinical QI projects improving clinical processes. Conclusions: This study developed a curriculum that successfully prepares residents to practice QI principles and lead multidisciplinary QI projects while demonstrating patient impact and behavior change. It offers an example of curriculum development and evaluation aided by QI science.