Outcomes of an Equity, Quality Improvement, and Patient Safety (EQuIPS) Curriculum in Community Hospital-Based Family...

Patient safety, quality improvement, and health equity training in graduate medical education are important. However, effective curriculum development in these complex domains remains challenging.

To evaluate the impact of EQuIPS (Equity, Quality Improvement, and Patient Safety), a mandatory, longitudinal curriculum for family medicine residents using Kirkpatrick Model of evaluation.

This study employed a quasi-experimental design across three phases (pre-EQuIPS, during EQuIPS rollout, post-EQuIPS) with retrospective data collection. We analyzed data from residents graduating from academic years 2016 through 2024 where EQuIPS was implemented a multifaceted bundled intervention. The outcomes were measured using Kirkpatrick Levels 2, 3, and 4 defined as completion of certification, reported participation in projects, and leadership of projects demonstrated by presentation or publication. Demographics between the three groups were evaluated using the Chi-squared test for comparability. Statistical Process Control (SPC) charts were used for 3-phase analysis, while Kruskal-Wallis, Wilcoxon rank sum tests, and Poisson regression analysis were applied to draw inferences of association.

A total of 51 residents graduated in the study period. The three groups were comparable with regards to gender or race while medical school background was significant (P < .001). SPC phase analysis revealed a process shift in resident engagement in interdisciplinary EQuIPS projects (Kirkpatrick Level 3) and completion of projects presented nationally or published (Kirkpatrick Level 4) post-implementation. The Kruskal-Wallis test indicated a significant difference in scholarly research involvement across the three phases (P < .001). Pairwise comparisons >10-fold increase in scholarly activity from pre- to post-implementation (P < .001) confirmed with Poisson regression after controlling for medical school.

The EQuIPS curriculum was associated with enhanced resident competency in equity, quality improvement, and patient safety. This model is a potentially valuable framework for other residency programs aiming to meet accreditation requirements and improvement and promote continuous improvement.