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Updated: Jul 7, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Medical students learn to assess care using the healthcare matrix
Doris C Quinn1, John W Bingham, Nader A Shourbaji
1Division of Medical Education and Administration, Vanderbilt University Medical Center, Nashville, TN, USA.
Background:
The Institute of Medicine identified six Aims for Improvement to drive the transformation of healthcare. Simultaneously, the Accreditation Council for Graduate Medical Education issued six competencies as part of the training of residents. American Board of Medical Specialties has also endorsed these competencies for maintenance of certification. Many training programs have struggled with the implementation of these competencies.
Aim:
This article describes two applications of The Healthcare Matrix which teaches the Core Competencies while leveraging the IOM? Aims for Improvement? as a means of anchoring the competencies in care of patients.
Method:
Third year medical students used the Matrix to identify the facilitators and barriers to quality of care. Second year internal medicine residents also use the Matrix during their ambulatory rotation.
Results:
Learners gained new insights into patient issues by using the Matrix and analysis of multiple matrices identified ?themes? of what needed to be improved. When taught the tools and methods of quality improvement, medical students and residents learn to lead the improvement of care.
Conclusion:
The Matrix has changed the way conferences are held because they bring all the competencies to bear on the discussion. There is less of a focus on the ?individual? and more on the systems in need improvement.
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