SAFE QI – a framework to overcome the challenges of implementing a quality improvement curriculum into a residency program

Abstract

Quality improvement (QI) is an essential component of medical practice. Medical students and residents must learn the skills to conduct clinical QI during their educational programs. Medical educators must create and implement a curriculum in QI to empower their students to develop this skill and knowledge. However, developing and implementing a QI curriculum may be challenging for some residency programs. Residency programs with a relatively short duration of training – for example, only 2 years – may be unable to implement an extensive QI curriculum without siphoning away time for other learning objectives. Small residency programs may lack faculty with expertise to teach this topic. Residency programs with only a few residents may find it difficult to evaluate the success of a QI curriculum using robust statistical analysis. These residency programs need a QI curriculum with several features. The curriculum must be deliverable in a short period of time. There must be tools to assess the residents’ attainment of the curricular objectives. The curriculum must give the residents practical skills to develop their own QI initiatives. Finally, there must be simple methods to evaluate the curriculum’s effectiveness. To address these goals, we developed the SAFE QI (QI curriculum which is short, assessed, functional, and effective) framework for the 2-year subspecialty respirology residency program at the University of Alberta. There are 2–3 entrants per year for a total of 4–6 residents. This framework helps medical educators overcome the challenges of implementing a QI curriculum into their educational programs. This article illustrates how this framework was used to develop and deliver an institution’s own QI curriculum.

Implementation and Evaluation of Quality Improvement Training in Surgery

“…In the past decade, there have been some notable examples on the development and reporting of specialty-specific structured QI curricula outside surgery. These include: psychiatry, [43][44][45][46] family medicine, [47][48][49] internal medicine, [50][51][52][53][54] medicine, 55,56 preventive medicine, 57,58 child neurology, 59 pediatric medicine, 60 interdisciplinary pediatric medicine, [61][62][63][64][65] neonatal intensive care, 66 respiratory subspecialties, 67 anesthesiology, 68 palliative care, 69 physical medicine and rehabilitation, 70 geriatric residency, 71 and obstetrics-gynecology. 72 QI courses are reported in undergraduate 73,74 and graduate medical education.…”

A Longitudinal Curriculum for Quality Improvement, Leadership Experience, and Scholarship in a Family Medicine Residency Program

“…Educational interventions that accomplish multiple educational goals simultaneously are desirable for their efficiency, as residency programs are challenged to meet all educational directives. 5 A strategy for linking resident training in QI with scholarship has been published, 6 but descriptions of existing curricula describe training that occurs in a single year, 7 expect residents to work in isolation, 8 and lack scholarship support. [7][8][9] The aim of this study was to evaluate a Skills-based Experiential Embedded Quality Improvement (SEE-QI) curriculum that can be used for multiple missions: to train residents in QI, leadership, and scholarship.…”

“…5 A strategy for linking resident training in QI with scholarship has been published, 6 but descriptions of existing curricula describe training that occurs in a single year, 7 expect residents to work in isolation, 8 and lack scholarship support. [7][8][9] The aim of this study was to evaluate a Skills-based Experiential Embedded Quality Improvement (SEE-QI) curriculum that can be used for multiple missions: to train residents in QI, leadership, and scholarship. The goals of the curriculum are to achieve high resident competency in QI, provide resident leadership experience, and increase scholarship.…”