Teaching Quality Improvement: The Use of Education Theories Across the Medical Education Spectrum

Abstract

It is well recognized that the principles and practices of patient safety and quality improvement (QI) need to be included in medical education. The implementation of patient safety and QI learning experiences at the undergraduate medical education (UME) and graduate medical education (GME) levels has been variable. Consistent teaching of QI across the UME-GME-continuing medical education (CME) spectrum may result in a systemic change of improved patient care and patient safety in clinical practice. We propose using education theories to frame the development of QI curricula for a longitudinal integration in medical education and clinical practice. The basic principles of four education theories, namely, reflective practice, deliberate practice, social constructivism, and organizational learning, are briefly described, and examples of their applications to QI teaching are discussed. The incorporation of education theory into the design and implementation of a longitudinal QI curriculum threaded across the UME-GME-CME spectrum may empower learners with a comprehensive and lasting understanding of QI principles and training in patient safety practice, which are essential prerequisites for the formation of a physician workforce capable of creating sustainable change in patient care.

Systems-Based Practice in Graduate Medical Education: Evolving Toward an Ideal Future State

“…To create systems thinkers with a broad toolbox of systems-related skills, faculty and programs are going to need a spectrum of teaching methodologies that goes beyond online modules and experiential learning via QI projects. New approaches that promote deeper engagement and connection with the material, such as transformational learning, 34 simulation, 35 game-based learning, 36,37 and other innovative techniques 38 that can create more meaningful and realistic learning experiences, will be needed. Additionally, efforts should be made to draw stronger connections between SBP and issues that learners perceive as relevant and meaningful.…”

Effects of an Experiential Learning Curriculum on Systems-Thinking

“… 1 Multiple articles have called for explicit descriptions of how theory is used in quality improvement and patient safety (QI/PS) education, which are components of HSS. 2 - 6 Though there are many theories that could act as a lens through which to view and create QI/PS curriculum, experiential learning theory is often referenced in QI/PS education, but its application to QI/PS is not always explicitly described. 2 To address this need for empirical investigation, we designed a QI curriculum for residents using experiential learning.…”