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Faculty-Resident "Co-learning": A Longitudinal Exploration of an Innovative Model for Faculty Development in Quality
Brian M Wong1, Joanne Goldman, Jeannette M Goguen
1B. Wong is associate professor, Department of Medicine, and associate director, Centre for Quality Improvement and Patient Safety, both at the University of Toronto, Toronto, Ontario, Canada. He is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.J. Goldman is research education lead, Centre for Quality Improvement and Patient Safety, University of Toronto, Toronto, Ontario, Canada.J. Goguen is associate professor, Department of Medicine, and director, Internal Medicine Program, both at the University of Toronto, Toronto, Ontario, Canada. She is also staff physician, Division of Endocrinology, St. Michael's Hospital, Toronto, Ontario, Canada.C. Base is administrative assistant and program administrator, Co-Learning Quality Improvement Curriculum, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.L. Rotteau is program manager, Centre for Quality Improvement and Patient Safety, and doctoral candidate, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.E. Van Melle is senior education scientist, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.A. Kuper is associate professor, Department of Medicine, and scientist, Wilson Centre for Research in Education, University Health Network, both at the University of Toronto, Toronto, Ontario, Canada. She is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.K. Shojania is professor, Department of Medicine, and director, Centre for Quality Improvement and Patient Safety, both at the University of Toronto, Toronto, Ontario, Canada. He is also staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Purpose:
To examine the effectiveness of co-learning, wherein faculty and trainees learn together, as a novel approach for building quality improvement (QI) faculty capacity.
Method:
From July 2012 through September 2015, the authors conducted 30 semistructured interviews with 23 faculty participants from the Co-Learning QI Curriculum of the Department of Medicine, Faculty of Medicine, University of Toronto, and collected descriptive data on faculty participation and resident evaluations of teaching effectiveness. Interviewees were from 13 subspecialty residency programs at their institution.
Results:
Of the 56 faculty participants, the Co-Learning QI Curriculum trained 29 faculty mentors, 14 of whom taught formally. Faculty leads with an academic QI role, many of whom had prior QI training, reinforced their QI knowledge while also developing QI mentorship and teaching skills. Co-learning elements that contributed to QI teaching skills development included seeing first how the QI content is taught, learning through project mentorship, building experience longitudinally over time, a graded transition toward independent teaching, and a supportive program lead. Faculty with limited QI experience reported improved QI knowledge, skills, and project facilitation but were ambivalent about assuming a teacher role. Unplanned outcomes for both groups included QI teaching outside of the curriculum, applying QI principles to other work, networking, and strengthening one's QI professional role.
Conclusions:
The Co-Learning QI Curriculum was effective in improving faculty QI knowledge and skills and increased faculty capacity to teach and mentor QI. Findings suggest that a combination of curriculum and contextual factors were critical to realizing the curriculum's full potential.
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