Impact of a competency based curriculum on quality improvement among internal medicine residents
Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among...
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Published in | BMC medical education Vol. 14; no. 1; p. 252 |
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Main Authors | , |
Format | Journal Article |
Language | English |
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England
BioMed Central Ltd
28.11.2014
BioMed Central |
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Abstract | Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents.
This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects.
Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day.
The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. |
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AbstractList | Background Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. Methods This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Results Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. Conclusion The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. BACKGROUNDTeaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents.METHODSThis was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects.RESULTSOverall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day.CONCLUSIONThe competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. Doc number: 252 Abstract Background: Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The literature on QI curricula for internal medicine residents is limited. We sought to evaluate the impact of a competency based curriculum on QI among internal medicine residents. Methods: This was a prospective, cohort study over four years (2007-2011) using pre-post curriculum comparison design in an internal medicine residency program in Canada. Overall 175 post-graduate year one internal medicine residents participated. A two-phase, competency based curriculum on QI was developed with didactic workshops and longitudinal, team-based QI projects. The main outcome measures included self-assessment, objective assessment using the Quality Improvement Knowledge Assessment Tool (QIKAT) scores to assess QI knowledge, and performance-based assessment via presentation of longitudinal QI projects. Results: Overall 175 residents participated, with a response rate of 160/175 (91%) post-curriculum and 114/175 (65%) after conducting their longitudinal QI project. Residents' self-reported confidence in making changes to improve health increased and was sustained at twelve months post-curriculum. Self-assessment scores of QI skills improved significantly from pre-curriculum (53.4 to 69.2 percent post-curriculum [p-value 0.002]) and scores were sustained at twelve months after conducting their longitudinal QI projects (53.4 to 72.2 percent [p-value 0.005]). Objective scores using the QIKAT increased post-curriculum from 8.3 to 10.1 out of 15 (p-value for difference <0.001) and this change was sustained at twelve months post-project with average individual scores of 10.7 out of 15 (p-value for difference from pre-curriculum <0.001). Performance-based assessment occurred via presentation of all projects at the annual QI Project Podium Presentation Day. Conclusion: The competency based curriculum on QI improved residents' QI knowledge and skills during residency training. Importantly, residents perceived that their QI knowledge improved after the curriculum and this also correlated to improved QIKAT scores. Experiential QI project work appeared to contribute to sustaining QI knowledge at twelve months. |
ArticleNumber | 252 |
Audience | Academic |
Author | Wong, Roger Y Fok, Mark C |
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Copyright | COPYRIGHT 2014 BioMed Central Ltd. 2014 Fok and Wong; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Fok and Wong; licensee BioMed Central Ltd. 2014 |
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References_xml | – volume: 32 start-page: 638 issue: 8 year: 2010 ident: 252_CR10 publication-title: Med Teach doi: 10.3109/0142159X.2010.501190 contributor: fullname: JR Frank – volume: 3 start-page: 131 issue: 3 year: 2003 ident: 252_CR5 publication-title: Ambul Pediatr doi: 10.1367/1539-4409(2003)003<0131:IICIRE>2.0.CO;2 contributor: fullname: JJ Mohr – volume: 9 start-page: 1242 issue: 11 year: 2002 ident: 252_CR18 publication-title: Acad Emerg Med doi: 10.1111/j.1553-2712.2002.tb01584.x contributor: fullname: SR Hayden – volume: 320 start-page: 53 issue: 1 year: 1989 ident: 252_CR1 publication-title: N Engl J Med doi: 10.1056/NEJM198901053200110 contributor: fullname: DM Berwick – ident: 252_CR3 – volume: 32 start-page: 631 issue: 8 year: 2010 ident: 252_CR11 publication-title: Med Teach doi: 10.3109/0142159X.2010.500898 contributor: fullname: JR Frank – volume: 84 start-page: 1757 issue: 12 year: 2009 ident: 252_CR4 publication-title: Acad Med doi: 10.1097/ACM.0b013e3181bf53ab contributor: fullname: CA Patow – volume: 2 start-page: 8 year: 2008 ident: 252_CR15 publication-title: Open Gen and Intern Med J doi: 10.2174/1874076600802010008 contributor: fullname: RY Wong – volume: 25 start-page: 211 issue: 3 year: 2010 ident: 252_CR6 publication-title: Am J Med Qual doi: 10.1177/1062860609357466 contributor: fullname: CS Kim – volume: 19 start-page: 496 issue: 5 Pt 2 year: 2004 ident: 252_CR9 publication-title: J Gen Intern Med doi: 10.1111/j.1525-1497.2004.30102.x contributor: fullname: G Ogrinc – volume: 21 start-page: 317 issue: 5 year: 2006 ident: 252_CR17 publication-title: Am J Med Qual doi: 10.1177/1062860606291136 contributor: fullname: P Varkey – volume: 78 start-page: 748 issue: 7 year: 2003 ident: 252_CR20 publication-title: Acad Med doi: 10.1097/00001888-200307000-00019 contributor: fullname: G Ogrinc – volume: 312 start-page: 619 issue: 7031 year: 1996 ident: 252_CR2 publication-title: BMJ doi: 10.1136/bmj.312.7031.619 contributor: fullname: DM Berwick – volume: 29 start-page: 642 issue: 7 year: 2007 ident: 252_CR12 publication-title: Med Teach doi: 10.1080/01421590701746983 contributor: fullname: JR Frank – volume: 89 start-page: 1386 issue: 10 year: 2014 ident: 252_CR22 publication-title: Acad Med doi: 10.1097/ACM.0000000000000456 contributor: fullname: MK Singh – volume: 80 start-page: 571 issue: 6 year: 2005 ident: 252_CR7 publication-title: Acad Med doi: 10.1097/00001888-200506000-00012 contributor: fullname: ES Holmboe – volume: 3 start-page: 26 issue: 1 year: 2008 ident: 252_CR13 publication-title: Can J Gen Int Med contributor: fullname: RY Wong – volume: 2 start-page: 35 issue: 1 year: 2007 ident: 252_CR14 publication-title: Can J Gen Int Med contributor: fullname: RY Wong – volume: 85 start-page: 1425 issue: 9 year: 2010 ident: 252_CR21 publication-title: Acad Med doi: 10.1097/ACM.0b013e3181e2d0c6 contributor: fullname: BM Wong – volume: 79 start-page: S65 issue: 10 Suppl year: 2004 ident: 252_CR8 publication-title: Acad Med doi: 10.1097/00001888-200410001-00020 contributor: fullname: AM Djuricich – ident: 252_CR16 – volume: 14 start-page: 147 issue: 2 year: 2000 ident: 252_CR19 publication-title: J Interprof Care doi: 10.1080/713678555 contributor: fullname: GD Cleghorn |
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Snippet | Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care. The... Background Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care.... Doc number: 252 Abstract Background: Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and... BACKGROUNDTeaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care.... BACKGROUND: Teaching quality improvement (QI) principles during residency is an important component of promoting patient safety and improving quality of care.... |
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Title | Impact of a competency based curriculum on quality improvement among internal medicine residents |
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