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A Recipe for a Continuous Quality Improvement Program in Surgical Residency.

Krysta M Sutyak1, Terry Fisher2, David H Kim3

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Summary

A new quality improvement (QI) curriculum effectively educated general surgery residents, increasing their knowledge and participation in QI activities. The multifaceted approach, incorporating lectures and practical projects, proved feasible and successful.

Keywords:
curriculumgeneral surgerygraduate medical educationquality improvementresidency

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Area of Science:

  • Medical Education
  • Surgical Training
  • Quality Improvement Science

Background:

  • General surgery residency programs require robust training in quality improvement (QI).
  • Effective QI education is essential for enhancing patient safety and healthcare outcomes.
  • Existing curricula may lack comprehensive didactic and practical components.

Purpose of the Study:

  • To design and implement a multifaceted QI educational curriculum for general surgery residents.
  • To analyze the effectiveness of the QI curriculum in improving resident knowledge, skills, and interest.
  • To identify key factors for successful QI curriculum implementation in residency programs.

Main Methods:

  • Prospective study utilizing Plan-Do-Study-Act (PDSA) methodology over four academic years (2020-2024).
  • Implementation of a three-pronged curriculum: didactic lectures, resident-led QI projects, and QI-focused morbidity and mortality conferences.
  • Longitudinal cohort assessment with surveys at the end of each PDSA cycle to evaluate educational impact and resident engagement.

Main Results:

  • Improvements observed in resident education on QI topics, participation in QI activities, and knowledge of QI principles.
  • Resident-led, faculty-mentored QI projects were successfully implemented, leading to real-time QI work completion.
  • Plan-Do-Study-Act (PDSA) methodology facilitated adaptation to barriers, such as transitioning to virtual lectures and creating protected time for QI projects.

Conclusions:

  • A multifaceted QI curriculum integrating didactic and practical elements is feasible and effective for general surgery residency programs.
  • The curriculum significantly increased residents' knowledge, comfort, and interest in quality improvement.
  • Faculty support, resident engagement, program management, and leadership are critical for successful QI curriculum implementation.