Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department.

Area of Science:

• Medical Education
• Quality Improvement
• Healthcare Systems

Background:

• The Association of American Medical Colleges (AAMC) emphasizes identifying system failures and fostering a culture of safety.
• Core Entrustable Professional Activities for Entering Residency (Core EPAs) include contributing to safety and improvement.
• Action Learning Projects (ALPs) offer a potential method for implementing evidence-based practices.

Purpose of the Study:

• To assess the feasibility of utilizing medical students' ALPs to accelerate the adoption of evidence-based care pathways.
• To implement and evaluate these pathways for three common emergency department (ED) diagnoses: atrial fibrillation, congestive heart failure, and pulmonary embolism.

Main Methods:

• Prospective quality improvement (QI) initiatives were conducted over six months in three hospitals.
• Third-year medical students, mentored by emergency physicians, worked on ALPs.
• Students received support including IT, lean management expertise, and access to data on patient disposition.

Main Results:

• Students successfully completed QI processes, including literature reviews and stakeholder analysis.
• They developed tools like flow diagrams, clinical aids, and educational programs.
• All three evidence-based guidelines were implemented, with 86% of ED providers comfortable involving students in future QI initiatives.

Conclusions:

• Aligning medical students in small groups with mentors facilitates QI implementation.
• This approach enables students to learn QI processes and efficiently translate evidence-based medicine into practice.
• Medical student engagement can expedite the movement of research findings to clinical application.