Using the Plan-Do-Study-Act (PDSA) Model for Continuous Quality Improvement of an Established Simulated Patient Program

Abstract

Objective: To describe the use of a continuous quality improvement process for strengthening our simulated patient (SP) program and the initial steps that have been implemented. 
 Innovation: A workgroup that included five clinical faculty with significant experience working with SPs and a strong interest in improving the SP program was developed. The Plan-Do-Study-Act model was used as it allowed for incremental quality improvement changes, in order to ensure a high-quality SP program designed to optimize student learning. Data were gathered from students, SPs, and faculty. Opportunities for improvement were prioritized based on anticipated benefits and available resources. Changes related to planning, implementation, and evaluation and feedback have been executed.
 Critical Analysis: Changes related to planning that were implemented included developing handbooks for SPs, faculty, and graduate student instructors, as well as material for students in order to better describe the program. SPs are now referred to as “simulated” as opposed to “standardized” as part of a broader effort to clarify the purpose of SP interactions to students. Streamlined rubrics have been piloted, including electronic rubrics for first year students. SPs are being trained on fewer cases, in order to improve the training program. When possible, activities now take place in one large classroom instead of many small classrooms to improve oversight. Finally, additional feedback has been obtained from SPs via a retreat. These changes have been well received by students, SPs, and faculty. 
 Next Steps: The collection of this data and initial quality improvement changes provided a basis for hiring a full-time employee who will: dedicate 50% of their time to programmatic assessment of the SP program, support faculty with logistics and training, and be the face of our program to the students and SPs. Further, formal quantitative and qualitative assessment of the SP program has begun.
 
 Type: Note

Using the Higher Learning Commission’s Assessment Culture Matrix to Support Continuous Quality Improvement of a Simulated Patient Program

“…This group used the Plan-Do-Study-Act (PDSA) model to conduct an initial evaluation of the program and subsequently identified that the clinical faculty alone did not have the capacity to carry forth comprehensive CQI efforts vital to further develop the SP program. 5 With administrative leadership support, the College created a staff position focused on SP program development, administration, and evaluation. While creating and sustaining a culture of assessment is a team effort and requires buy-in from all stakeholders, finding a person dedicated to upholding the principles of CQI has helped our SP program maintain its commitment to assessment.…”

“…This group used the Plan-Do-Study- Act (PDSA) model to conduct an initial evaluation of the program and subsequently identified that the clinical faculty alone did not have the capacity to carry forth comprehensive CQI efforts vital to further develop the SP program. 5 …”

“…Simulated patient (SP) programs provide pharmacy students the opportunity to practice skills, such as taking a medication history, conducting focused physical assessments, making clinical decisions using critical thinking, adopting patientcentered communication, and recommending changes in medication therapy to a primary care provider in a safe environment. [1][2][3][4][5] Our SP program, within a 4-year pharmacy program at a public institution, started approximately 25 years ago. We have found that continuous quality improvement (CQI) is needed to ensure that the activities continue to be high quality and align with evolving pharmacy practice expectations for new graduates.…”

Changes in student perceptions and beliefs, self-efficacy, role identification, and behavioral intentions after participation in longitudinal interprofessional pain management simulation

“…Because this was a QI initiative, this was exempted from the necessity of ethical board approval. Because of the nature of this quality design, this will be written as a plan, do, study, act format (Fishman et al, 2013;Barker et al, 2018;AHRQ, 2018;IHI, 2019;Vordenberg et al, 2018).…”

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

“…However, the methodical integration of improvement cycles such as PDSA are often lacking in practice, largely due to the high resource requirements of frequent programmatic assessments and data review [ 10 ]. 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 to improve medical education sessions [ 11 , 12 ].…”