HonorHealth John C. Lincoln Medical Center
Problem: Quality improvement and patient safety (QIPS) competency requirements in residency have ignited the need to incorporate QIPS learning in the undergraduate medical education (G.M.E.) curriculum. The method of incorporation and assessment of these competencies during the surgical clerkship is not well described.
Approach: Third year medical students at Midwestern University in Arizona were introduced to a novel QIPS curriculum during the core general surgery rotation. The curriculum was introduced in 2019 after yearly curricular mapping revealed the need to incorporate QIPS learning. The aim was to introduce and assess a QIPS curriculum during the core surgical clerkship. The curriculum was incorporated in the existing curriculum by: (1) Introducing the students to the curriculum during an introductory workshop, (2) Including modules on the learning management system (LMS), CANVAS,(3) Finding a QIPS mentor, (4) Utilizing learning in the hospital/clinic realm to plan a QIPS project and posting on CANVAS and, (5) Providing feedback to another student on their QIPS project. The students were assessed by evaluating QIPS knowledge pre- and post-curriculum and their attitudes about the curriculum.
Outcomes: The QIPS curriculum was successful as evidenced by 100% completion of project plans and peer reviews for feedback. QIPS knowledge significantly increased after the completion of the curriculum. From July 2019 to May 2020, students completed 269 QIPS projects and peer reviews of projects. A voluntary QIPS knowledge assessment test (R-QIKAT) pre-curriculum (N=207), post curriculum R-QIKAT (N=105) and an attitudes survey (N=70) were utilized to assess the curriculum. Q.I. knowledge increased for all 3 questions with statistical significance for 2 of 3 questions on the assessment after experiencing the curriculum (question 2, p = 0.0020 and question 3, p = 0.0003). Furthermore, although most students had no prior QIPS education prior to this curriculum (56.5%), a high percentage of students thought that their QIPS knowledge increased (70%) and that the assignment was easily achievable (58.2%).
Next Steps: The curriculum will expand in several ways: (1) A QIPS workshop will be incorporated into the pre-rotation course to introduce QIPS, (2) the curriculum will be evaluated further using time measures and project outcomes, (3) other clinical education departments will be engaged to allow students to continue new or existing projects on their rotations other than surgery, (4) students will be permitted to maintain a project that the prior student on rotation planned but could not collect data and or analyze.
