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A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module.

Joel C Boggan, George Cheely, Bimal R Shah

    Journal of Graduate Medical Education
    |August 18, 2015
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    Summary

    A new online tool successfully engaged residents in quality improvement (QI) initiatives, significantly improving foot examination rates in diabetic patients. This adaptable tool can benefit other medical education programs.

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    Area of Science:

    • Medical Education
    • Quality Improvement
    • Digital Health Tools

    Background:

    • Engaging residents in large-scale quality improvement (QI) initiatives presents significant challenges.
    • Effective strategies are needed to foster resident participation in QI.

    Purpose of the Study:

    • To develop and implement a shared online tool for coordinating a quality improvement (QI) project within a large residency program.
    • To assess the effectiveness of the online tool in engaging residents and improving performance metrics.

    Main Methods:

    • A web-based QI tool guided residents through a two-phase evaluation of foot examinations in diabetic patients.
    • Residents reviewed patient records, entered data online, received performance feedback, and developed improvement plans.
    • Performance rates were compared between phases, and tool acceptability and feasibility were assessed.

    Main Results:

    • 92% of eligible residents participated in phase 1, with 79% completing phase 2.
    • Significant improvement in foot examination performance was observed, increasing from 52% to 73% (P < .001).
    • Tool development required 130 hours of programmer time; monthly management required 6 hours of administrator and faculty time.

    Conclusions:

    • An online tool effectively engaged residents in program-wide QI activities and improved a key quality metric.
    • The developed tool demonstrated success in enhancing resident participation and performance in quality improvement.
    • This online QI tool is adaptable for use in other graduate medical education programs and for faculty development.