Characterizing Quality Improvement Education in Anesthesiology Residencies: A Nationwide Survey

In 2017, the Accreditation Council for Graduate Medical Education (ACGME) formalized the inclusion of quality improvement (QI) in residency training. We sought to characterize how ACGME-accredited anesthesiology residency programs implement QI curricula, assess variation in curricular structure, and evaluate associations between curricula design and resident engagement.

We conducted a national survey of all ACGME-accredited anesthesiology residency programs in the United States. Program directors, associate program directors, or the department's quality and safety leader completed an anonymous survey assessing the structure, components, and resident engagement in QI curricula.

Totally, 31/159 programs completed the survey, with 25 programs reporting formal QI curricula. Residents in programs with formal curricula were more likely to develop or lead their own projects (52% versus 0%, P =0.028). In addition, programs with formal curricula included more total components than informal programs (6 versus 3, P <0.001) and more components of the Institute for Healthcare Improvement (IHI) Model for Improvement than those without formal curricula (3.95 versus 1.75, P =0.048). Notably, 84% of respondents supported centralized resources to enhance QI training.

Our results highlight the potential variability in how anesthesiology programs satisfy the 2017 ACGME QI requirements. Formal QI curricula were associated with higher reported levels of resident engagement and inclusion of more QI components in their curricula, including those from the IHI Model for Improvement, emphasizing the importance of structure and evidence-based strategies in QI education. The strong support for centralized resources underscores an opportunity to standardize QI education, ensuring improved access to a strong foundation of QI knowledge and skill. Due to the limited response rate and the nature of the study design, these results are best considered preliminary and intended to inform future inquiry.