Teaching quality improvement in the classroom and clinic: getting it wrong and getting it right

The world in which today's graduates will provide care is changing, as are expectations about caregivers' performance. Learning how to improve quality of care must occur during, and as part of, learning about patient care. In this article, I describe a continuous quality improvement learning program that was integrated into nursing students' education and a study evaluating the students' experiences with the implementation of the program through open-ended questions and focus groups. The program consisted of three parts: participating in a personal improvement project; observing and describing a patient process from the patient's perspective; and working in teams with process improvement in clinical practice. The findings indicated the students learned improvement methods and tools during their personal improvement projects, but their ability to translate that knowledge into action, and thereby improve patient care, was insufficiently developed through coaching, reflection, and role modeling. In other words, the experience was not integrated into the students' general education. In addition, faculty and clinical staff did not seem to be adequately informed and had limited knowledge of the students' clinical improvement projects.