Integrating a Resident-Driven Longitudinal Quality Improvement Curriculum Within an Ambulatory Block Schedule

Area of Science:

• Medical Education
• Healthcare Quality Improvement
• Internal Medicine Residency

Background:

• Quality improvement (QI) education is crucial for clinical practice and residency training.
• Existing barriers to QI teaching include lack of structure, mentorship, and time.
• Effective QI curricula are needed to overcome these challenges in residency programs.

Purpose of the Study:

• To develop and evaluate a longitudinal QI curriculum for an internal medicine residency.
• The curriculum was designed for programs with limited faculty resources.
• Assess the effectiveness of the QI curriculum on resident learning and practice.

Main Methods:

• Residents received dedicated QI research time every 8 weeks during ambulatory blocks.
• Small, inter-level resident groups (3-5) were mentored by two faculty and one chief resident.
• Didactic modules from the Institute for Healthcare Improvement were mandatory; feedback was collected via surveys.

Main Results:

• Over three years, 92-102 residents annually participated, completing 54 quality assessment and 18 QI projects.
• Six QI projects demonstrated statistically significant improvements in quality indicators.
• The program generated 69 abstracts/posters, with 13 presented nationally/regionally; 75% of residents and 63% of alumni found it practice-changing.

Conclusions:

• A longitudinal QI curriculum can be implemented with minimal faculty time (approx. 50 hours/year).
• The curriculum successfully increased QI-related publications and led to measurable improvements in quality.
• Alumni reported sustained positive impacts on their clinical practice after graduation.