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Culture change and mandating quality improvement
Thomas Bartlett1, Edward Hewertson1, Michael Vassallo1,2
1Department of Medicine, Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, Castle Lane East, Bournemouth, Dorset, UK.
The Clinical Teacher
|January 11, 2018
Summary
Mandatory quality improvement (QI) education for junior doctors increased knowledge but decreased motivation and positivity towards projects. This suggests mandatory QI training may stifle creativity and reduce its perceived value.
Area of Science:
- Medical Education
- Healthcare Quality Improvement
Background:
- A mandatory quality improvement (QI) education program was implemented for Foundation Year 1 (FY1) doctors.
- The program aimed to fulfill curriculum requirements and its effectiveness was evaluated through participant perceptions.
Purpose of the Study:
- To assess the impact of a mandatory QI education program on FY1 doctors' knowledge, attitudes, and motivation.
- To gather perceptions to refine the QI education program for future iterations.
Main Methods:
- A quasi-experimental design was employed, comparing data before and after the intervention.
- Self-rating questionnaires measured changes in knowledge and motivation.
- Comparison data were collected from the previous year's FY1 cohort.
Main Results:
- QI knowledge significantly increased post-intervention.
- However, participants showed decreased motivation to complete projects and less positive attitudes towards them.
- Doctors perceived QI projects as less important for professional development and less likely to generate long-term positive change.
Conclusions:
- While the QI program successfully delivered theoretical and experiential learning, mandatory participation may reduce junior doctors' innovative drive.
- The mandatory nature risks turning QI initiatives into a superficial 'tick-box' exercise.
- Refinement is needed to maintain the intrinsic value and engagement of QI education for junior doctors.
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