Linking Residency Training Effectiveness to Clinical Outcomes: A Quality Improvement Approach

Buckley, John D.; Joyce, Barbara; García, Ana Isabel Morales; Jordan, John R.; Scher, Eric

doi:10.1016/s1553-7250(10)36033-8

Cited by 24 publications

(10 citation statements)

References 11 publications

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“…These specific training interventions were investigated in six medical [97,102,107-109,111], five surgical [98-100,103,105] and three intensive care [95,96,104] studies, and one each in psychiatry [110], anesthesiology [106] and all specialties [101]. Three randomized controlled trials were included in this category [101,107,111].…”

Section: Resultsmentioning

confidence: 99%

“…Another randomized controlled trial in this category investigated a 40-hour role-play and feedback skills training program over eight months for residents, resulting in significantly higher patient satisfaction scores in the intervention group [101]. Seven of the 14 observational studies reported improved patient outcomes after implementation of a new training program [96,108], supervision [104,106] or simulator training and debriefing [95,97,105]. Six studies reported no difference in patient outcome [98-100,102,103,109] although one study did conclude that adherence to guidelines was better [109] and another study found that a redesign initiative reduced trainee workload and increased time for educational activities [102].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of the effects of residency training on patient outcomes

Leeuw

Lombarts

Arah

et al. 2012

BMC Med

144

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BackgroundResidents are vital to the clinical workforce of today and tomorrow. Although in training to become specialists, they also provide much of the daily patient care. Residency training aims to prepare residents to provide a high quality of care. It is essential to assess the patient outcome aspects of residency training, to evaluate the effect or impact of global investments made in training programs. Therefore, we conducted a systematic review to evaluate the effects of relevant aspects of residency training on patient outcomes.MethodsThe literature was searched from December 2004 to February 2011 using MEDLINE, Cochrane, Embase and the Education Resources Information Center databases with terms related to residency training and (post) graduate medical education and patient outcomes, including mortality, morbidity, complications, length of stay and patient satisfaction. Included studies evaluated the impact of residency training on patient outcomes.ResultsNinety-seven articles were included from 182 full-text articles of the initial 2,001 hits. All studies were of average or good quality and the majority had an observational study design. Ninety-six studies provided insight into the effect of 'the level of experience of residents' on patient outcomes during residency training. Within these studies, the start of the academic year was not without risk (five out of 19 studies), but individual progression of residents (seven studies) as well as progression through residency training (nine out of 10 studies) had a positive effect on patient outcomes. Compared with faculty, residents' care resulted mostly in similar patient outcomes when dedicated supervision and additional operation time were arranged for (34 out of 43 studies). After new, modified or improved training programs, patient outcomes remained unchanged or improved (16 out of 17 studies). Only one study focused on physicians' prior training site when assessing the quality of patient care. In this study, training programs were ranked by complication rates of their graduates, thus linking patient outcomes back to where physicians were trained.ConclusionsThe majority of studies included in this systematic review drew attention to the fact that patient care appears safe and of equal quality when delivered by residents. A minority of results pointed to some negative patient outcomes from the involvement of residents. Adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes. Limited evidence is available on the effect of residency training on later practice. Both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver high quality care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A systematic review of the effects of residency training on patient outcomes

Leeuw

Lombarts

Arah

et al. 2012

BMC Med

144

View full text Add to dashboard Cite

show abstract

“…Most showed no significant clinical outcomes,33 35 37 40–43 but some showed statistically significant improvement in diabetes measures, vaccination rates, chronic care measures and critical care measures 32 34 36 38 39…”

Section: Resultsmentioning

confidence: 99%

Republished: Key characteristics of successful quality improvement curricula in physician education: a realist review

Jones

Shipman

Ogrinc

2015

Postgraduate Medical Journal

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“…We wanted to ensure that our sleep medicine fellowship program teaches fellows foundational QI concepts and provides robust experience in applying this knowledge to real-life scenarios. Literature review showed that many scholarly articles detail QI curricula for residency programs, [4][5][6][7][8] but fewer describe QI curricula in fellowship programs. [9][10][11] Moreover, scant guidance is available on development and implementation of a QI curriculum into a single-year graduate medical education training program.…”

Section: Scientific Investigationsmentioning

confidence: 99%

Meeting ACGME and ABMS Quality Improvement Requirements in a Sleep Medicine Fellowship Program

Shelgikar

Priddy

Harrison

2017

Journal of Clinical Sleep Medicine

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Study Objectives: To describe a sustainable program of teaching and implementing quality improvement (QI) in a 12-month sleep medicine fellowship. Methods: We created a QI curriculum based on Accreditation Council for Graduate Medical Education (ACGME) and American Board of Medical Specialty (ABMS) Part IV Maintenance of Certification (MOC) requirements for QI. Two program faculty with prior QI training volunteered to mentor fellows. Our institution's central QI office houses QI experts who teach QI across the health system. One of these experts, referred to as the "QI consultant," helped us adapt QI teaching materials to include 4 online modules and 5 group sessions. Fellows worked in teams to complete 2 data-guided QI cycles. Results: The curriculum required 29 hours for fellows, 18 hours for faculty, and 55 hours for the QI consultant; now that teaching materials have been created, the QI consultant's involvement will decrease over time. Post-curriculum surveys showed that fellows' knowledge of QI concepts increased, as did their confidence performing QI activities. Fellows' QI projects objectively improved timeliness and quality of care for patients. Sleep medicine fellows and QI faculty mentors evaluated the curriculum positively. The curriculum met ACGME requirements for QI, and fellows and mentoring faculty received ABMS Part IV MOC credit upon completion of the curriculum. Conclusions: A QI curriculum can successfully be implemented into a 12-month sleep medicine fellowship to increase sleep medicine fellows' QI knowledge and confidence, meet ACGME and MOC requirements, and contribute to care of patients with sleep disorders. Keywords: education, fellowship, maintenance of certification, quality improvement, sleep disorders Citation: Shelgikar AV, Priddy C, Van Harrison R. Meeting ACGME and ABMS quality improvement requirements in a sleep medicine fellowship program.

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Linking Residency Training Effectiveness to Clinical Outcomes: A Quality Improvement Approach

Cited by 24 publications

References 11 publications

A systematic review of the effects of residency training on patient outcomes

A systematic review of the effects of residency training on patient outcomes

Republished: Key characteristics of successful quality improvement curricula in physician education: a realist review

Meeting ACGME and ABMS Quality Improvement Requirements in a Sleep Medicine Fellowship Program

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