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

A quality improvement activity to promote interprofessional collaboration among health professions students

OBJECTIVES

To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care.

DESIGN

Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process.

ASSESSMENT

One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience.

CONCLUSION

Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students.

Effecting the sixth core competency: a project-based curriculum

OBJECTIVE

In agreement with the Accreditation Council for Graduate Medical Education guidelines, a systems-based practice (SBP) curriculum was implemented to provide a hands-on, team-based experience, while providing an opportunity to contribute to quality improvement, and to develop a method to assess residents' understanding of SBP.

STUDY DESIGN

During departmental conferences, issues affecting our health care operations were identified. Seven teams were formed and the actionable items were investigated. The salient issues and potential solutions were presented to the department.

RESULTS

This project resulted in the development of tools designed to assess competency in SBP, communication skills, and professionalism. Completion of a pre- and posttest and annual oral examination questions revealed a significant improvement in the comprehension of SBP.

CONCLUSION

This project served as an effective educational forum for the competencies of SBP, communication skills, and professionalism. This initiative also offered improvement of patient care and/or educating peer providers, thereby fulfilling the goal of SBP in the process of education.

Development and implementation of a systems-based practice project requirement for radiology residents

RATIONALE AND OBJECTIVES

Radiology residents must now participate in a learning activity that involves identification and analysis of system errors and implementation of potential solutions. Evidence of participation must be documented in the resident's learning portfolio.

MATERIALS AND METHODS

An activity based on adult learning principles was designed for residents to increase their knowledge of health care systems and problems; gain experience in writing a proposal, conducting an investigation, and reporting results; organize and present information in a supportive environment; and document participation in their portfolio. Postgraduate year 2 residents identify a systems problem. A written proposal is required and must include a "plan" that includes a hypothesis, a methods section that explains what they will "do" as an intervention, a "study" that involves collection and analysis of relevant data, and a systems change or "act." Proposals approved by the program director are presented to the radiology department. Residents complete projects, evaluate their effectiveness, and present their results by spring of postgraduate year 3.

RESULTS

Goals, objectives, and guidelines were written. Assessment tools were identified. From 2006 to 2008, nine projects were proposed and conducted by 12 residents. Local and national systems issues were selected, and interventions involved residents, faculty, and medical students. A timeline was imposed to promote sustained effort.

CONCLUSION

Opportunities of daily work can be used to teach and learn systems-based practice concepts. Residents can use the scientific method to test effects of change on health care systems. Relevant and practical projects enable residents to learn while improving their clinical and learning environments.