A self-instructional model to teach systems-based practice and practice-based learning and improvement.

Area of Science:

• Medical Education
• Healthcare Quality Improvement
• Residency Training

Background:

• Systems-based practice (SBP) and practice-based learning and improvement (PBLI) became mandatory resident competencies in 1999.
• These concepts were novel to many medical professionals at the time of their implementation.

Purpose of the Study:

• To describe and evaluate the effectiveness of a 4-week clinical elective, Achieving Competence Today (ACT).
• To assess the ACT program's ability to teach residents SBP and PBLI.

Main Methods:

• The ACT program involved a 4-week active learning course with web-based support and a follow-up teaching experience.
• Curriculum included readings, activities, an improvement project, and weekly meetings with a non-expert preceptor.
• Evaluation utilized a before-after cross-comparison of ACT residents and control groups.

Main Results:

• ACT residents showed greater gains in knowledge (4.4/100) and self-assessed competency (11.3/100) compared to controls.
• Faculty preceptors' attitudes towards resident learning of SBP/PBLI became more positive (15.8/100).
• Principal investigators rated the ready-to-use curriculum highly (8.5/10).

Conclusions:

• The ACT program successfully increased residents' knowledge and self-perceived competency in SBP and PBLI.
• Faculty attitudes regarding the importance of resident learning in SBP/PBLI improved.
• Effective resident learning of SBP/PBLI does not necessitate faculty content expertise.