Applying the Plan-Do-Study-Act cycle in medical education to refine an antibiotics therapy active learning session

Abstract

Background Active learning improves learner engagement and knowledge retention. The application of continuous quality improvement methodologies, such as the Plan-Do-Study-Act (PDSA) framework, may be useful for optimizing medical education, including active learning sessions. We aimed to enhance student satisfaction and achievement of learning outcomes by applying the PDSA framework to an antibiotic utilization curriculum for medical students. Methods Guided by the Plan-Do-Study-Act framework, between February 2017 and July 2019, we developed, implemented, and revised an active learning session for medical students, focused on appropriate utilization of antibiotics during their Internal Medicine clerkship. Results Across twelve sessions, 367 students (83.4%) completed the post-evaluation survey. Although baseline ratings were high (97% of respondents enjoyed the “active learning” format), constructive comments informed iterative improvements to the session, such as modifying session timing, handouts and organization of the gaming component. Intervention 3, the last improvement cycle, resulted in more favorable ratings for the active learning format (p = 0.015) improvement in understanding antibiotics and their clinical application (p = 0.001) compared to Baseline ratings. Conclusions This intervention suggests that active learning, with regular incorporation of student feedback vis-à-vis a PDSA cycle, was effective in achieving high student engagement in an Internal Medicine core clerkship session on antibiotic therapy. Iterative interventions based on student feedback, such as providing an antibiotic reference table and answer choices for each case, further improved student receptivity and perceived educational value. The study findings have potential implications for medical education and suggest that the application of the PDSA cycle can optimize active learning pedagogies and outcomes.

Towards high reliability in national pathology education: Evaluating the United States and Canadian Academy of Pathology educational product

“…As the name suggests, the PDSA cycle involves identifying a goal (“plan”) (in this case, improving the educational outlier or underperformer), enacting a change (“do”) (implementing the agreed upon intervention), observing the result (“study”) (gathering the new crop of pertinent data), and then acting on what is learned (“act”) (continuing the intervention or changing the intervention). 32 , 33 Finally, while we did not discuss the qualitative survey comments in this article, they are an invaluable source of feedback and ideas for directions of improvement. An educational organization looking to improve quality would be well-served by spending considerable time looking through learners’ comments.…”

Content and process: using continuous quality improvement to teach and evaluate learning outcomes in quality improvement residency education

“…Emerging literature suggests this approach is both feasible and appropriate for educational interventions. [16][17][18][19]…”

“…Through a CQI framework, instructors can test curricular changes in each teaching session and decide to adopt or abandon changes. Emerging literature suggests this approach is both feasible and appropriate for educational interventions 16–19…”

Assessment of quality improvement of simulation‐based learning using an evidence‐based framework in dental education

“…13,14 Though it is typically applied to organizational realms; it can be beneficial for educational interventions. 15 Despite the broad application of PDSA cycles in quality improvement paradigms, and the emphasis on CQI in curriculum development, there remains a paucity of data regarding the usefulness of applying the PDSA cycle in dental education. 16,17 Though a variety of simulation education tools and methodologies are available in teaching universities, 18…”

“…This four step PDSA model provides structure for iterative testing of changes to improve quality of systems and is widely accepted in health care improvement 13,14 . Though it is typically applied to organizational realms; it can be beneficial for educational interventions 15 . Despite the broad application of PDSA cycles in quality improvement paradigms, and the emphasis on CQI in curriculum development, there remains a paucity of data regarding the usefulness of applying the PDSA cycle in dental education 16,17 …”