Instituting systems-based practice and practice-based learning and improvement: a curriculum of inquiry.

Area of Science:

• Medical Education
• Graduate Medical Training
• Healthcare Quality Improvement

Background:

• Accreditation Council for Graduate Medical Education (ACGME) mandates system-based practice (SBP) and practice-based learning and improvement (PBLI) in residency programs.
• Internal medicine residency curricula require integration of these essential competencies.
• A novel curriculum was developed to address these ACGME requirements.

Purpose of the Study:

• To evaluate the effectiveness of a structured curriculum in enhancing resident skills in SBP and PBLI.
• To assess resident self-reported knowledge, attitudes, and skills in SBP and PBLI.
• To determine the quality of resident-generated quality improvement and research projects.

Main Methods:

• Implementation of a seminar series and a year-long mentored curriculum for internal medicine residents.
• Residents engaged in assigned readings, structured discussions, and faculty-guided quality improvement or research projects.
• Assessment through resident surveys and blinded faculty review of project feasibility, impact, and appropriateness.

Main Results:

• Residents demonstrated improved understanding of practice context and enhanced ability to conduct quality improvement projects.
• Faculty reviewers rated resident projects favorably for feasibility, impact, and appropriateness.
• The curriculum generated 11 quality improvement and research projects, with hospital leadership acknowledging its value.

Conclusions:

• A structured, residency-based curriculum effectively fosters resident competence in SBP and PBLI.
• This educational approach benefits residents by imparting crucial knowledge and skills.
• Hospitals benefit from trainees who actively contribute to resolving clinical issues and meeting accreditation standards.