Developing and Implementing a Quality Improvement Curriculum in a Large Internal Medicine Residency Program

Residency programs face increasing expectations to grow competency in system-based practice and quality improvement (QI) among trainees. Organizations like the American Board of Internal Medicine and the Accreditation Council for Graduate Medical Education have included QI knowledge in their recertification and accreditation requirements. We describe our experiences over a decade of sustaining a longitudinal experiential QI curriculum at a large Internal Medicine residency program.

Each resident participated in interactive seminars as well as a faculty-mentored, team-based QI project. Each project was formally evaluated at an end-of-year poster presentation.

One hundred thirty-six projects were completed between 2007 and 2016. A presurvey of 51 PGY-1 residents (59%) and a postsurvey of 50 PGY-2 and PGY-3 residents (46%) demonstrated increased comfort leading a QI project and improved knowledge of QI principles. We continue a modified version of the curriculum to accommodate the residency program's restructured ambulatory teaching experiences and the impacts of the COVID-19 pandemic.

Implementing a performance improvement curriculum based in a resident continuity clinic is feasible and affords several advantages. In applying QI methodologies, residents learn how to measure adherence with current evidence-based medicine guidelines and develop interventions to maintain positive momentum within the reality of busy clinical practice.