Implementation and Evaluation of Quality Improvement Training in Surgery: A Systematic Review

Area of Science:

• Medical Education
• Surgical Training
• Quality Improvement Science

Background:

• Global emphasis on enhancing quality improvement (QI) capacity within surgical services.
• Lack of standardized specifications for QI content and delivery in surgical education.
• Need to understand current approaches to QI skills training for surgeons.

Purpose of the Study:

• To review and evaluate the methods used for teaching quality improvement (QI) skills to surgeons and surgical residents.
• To identify common QI techniques, training materials, and delivery strategies in surgical education.
• To assess the reporting quality and methodological rigor of QI educational interventions in surgery.

Main Methods:

• Systematic review of QI educational intervention studies targeting surgeons or surgical trainees.
• Searched 10 databases for studies published up to 2017.
• Extracted data on teaching methods, training materials, implementation frameworks, and strategies.

Main Results:

• Seventeen studies were included, revealing diverse QI techniques (e.g., process mapping, lean principles).
• Training delivery commonly combined didactic teaching with practical QI project work.
• Implementation details and study methodologies were often poorly reported, with low scores on psychometric reporting.

Conclusions:

• Surgical QI training can employ various established QI techniques through blended didactic and practical approaches.
• The true effectiveness and impact of QI training are uncertain due to methodological limitations and inconsistent reporting.
• Advancement requires larger-scale, multi-institutional educational QI studies with improved rigor and clarity.