Practice-based learning and improvement: a curriculum in continuous quality improvement for surgery residents

David F Canal, Laura Torbeck, Alexander M Djuricich
Archives of Surgery 2007, 142 (5): 479-82; discussion 482-3

HYPOTHESIS: Surgery residents can learn continuous quality improvement (CQI) principles within a structured curriculum and propose quality improvement projects.

DESIGN: Curriculum within a surgical residency program.

SETTING: A university surgical residency program with multiple hospital training sites.

PARTICIPANTS: Fifteen surgical residents during the dedicated research year.

INTERVENTION: A curriculum in CQI that focuses on devising a quality improvement project.

MAIN OUTCOME MEASURES: Resident self-reported attitudes about quality improvement and implementation of resident-initiated quality improvement projects.

RESULTS: Resident survey data demonstrated an improvement in knowledge, self-efficacy, and experiences within CQI. Fifteen individual residents, within smaller teams, created 4 quality improvement projects worthy of implementation.

CONCLUSIONS: A structured CQI curriculum can be successfully integrated into a general surgery residency program. Residents can learn the skill of constructing CQI project ideas within the framework of the plan-do-study-act cycle. Residents are eager to make improvements in their local system of residency. By giving them the tools to critically investigate systems improvement and a much needed ear to hear their concerns and suggestions for improvement, we found ways to potentially enhance patient care and developed ideas to improve the education of future surgeons. In doing so, we provided the residents with "buy-in" into their residency program, while addressing the competency of practice-based learning and improvement required by the Accreditation Council for Graduate Medical Education for resident education.

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