Article type
Year
Abstract
Background:
The 2001 Institute of Medicine’s report, Crossing the Quality Chasm, revealed a fractured American Healthcare System and a critical need for quality improvement (QI) training. Since that time, medical education accrediting bodies such as AAMC and ACGME have incorporated the findings and implemented QI into the training curriculum at both the level of medical student and residents, respectively. In addition, residents are required to engage in quality improvement activities during their training.
Earlier studies indicated a general recognition of the need and benefits of QI training. Beyond meeting accreditation requirements, it is also critical to determine the impact of a curriculum. The Kirkpatrick’s model has been used in medical education and other fields to assess the learner and the impact of a curriculum. It is based on outcomes in the context of four areas: participation, modification, behavioral change, and benefit to organization or patients.
Objective:
The objective of this study was to determine the QI curriculum learning impact using the Kirkpatrick model. This inquiry was part of a comprehensive systematic review to determine current training and curriculum opportunities and challenges in teaching quality improvement to medical students.
Methods:
Publications in PubMed, EMBASE, and SCOPUS from January 1, 2009 to December 31, 2018 were identified using a structured search strategy. The PRISMA guideline was followed.
For comparison, we identified fundamental components in each article including study population, intervention performed, educational QI component, major findings, and learning outcomes. We utilized the Kirkpatrick’s model to determine trainee learning outcomes: impact on learners’ satisfaction, changes in attitudes, knowledge and skills, changes in learners’ behavior, organizational changes, and patient benefits. Simple descriptive statistics such as frequency and percentage were generated to summarize the results.
Results:
A total of 29 studies were identified from 3,889 peer-reviewed abstracts. Results indicated that Kirkpatrick’s Model level 2b: modification of knowledge/skill (65.5%) and level 4a: change in organizational practice (69%) were found to be most prevalent across the studies. Compared to previous systematic reviews on QI training for medical students, there was a significant increase in studies demonstrating Kirkpatrick level 4b: patient benefits (27.6%).
Conclusions:
The trends are consistent with medical school QI training becoming more effective and shifting from an individualized effect to a larger organizational effect. Patient benefits were also observed in a significant number of studies.
Patient or healthcare consumer involvement:
The patients’ needs and interest were represented in the studies reviewed in different ways. Trainees worked on problems critical to patients, utilized real patient data for audit, and learned to work in inter-professional teams to effectively improve patient care.
The 2001 Institute of Medicine’s report, Crossing the Quality Chasm, revealed a fractured American Healthcare System and a critical need for quality improvement (QI) training. Since that time, medical education accrediting bodies such as AAMC and ACGME have incorporated the findings and implemented QI into the training curriculum at both the level of medical student and residents, respectively. In addition, residents are required to engage in quality improvement activities during their training.
Earlier studies indicated a general recognition of the need and benefits of QI training. Beyond meeting accreditation requirements, it is also critical to determine the impact of a curriculum. The Kirkpatrick’s model has been used in medical education and other fields to assess the learner and the impact of a curriculum. It is based on outcomes in the context of four areas: participation, modification, behavioral change, and benefit to organization or patients.
Objective:
The objective of this study was to determine the QI curriculum learning impact using the Kirkpatrick model. This inquiry was part of a comprehensive systematic review to determine current training and curriculum opportunities and challenges in teaching quality improvement to medical students.
Methods:
Publications in PubMed, EMBASE, and SCOPUS from January 1, 2009 to December 31, 2018 were identified using a structured search strategy. The PRISMA guideline was followed.
For comparison, we identified fundamental components in each article including study population, intervention performed, educational QI component, major findings, and learning outcomes. We utilized the Kirkpatrick’s model to determine trainee learning outcomes: impact on learners’ satisfaction, changes in attitudes, knowledge and skills, changes in learners’ behavior, organizational changes, and patient benefits. Simple descriptive statistics such as frequency and percentage were generated to summarize the results.
Results:
A total of 29 studies were identified from 3,889 peer-reviewed abstracts. Results indicated that Kirkpatrick’s Model level 2b: modification of knowledge/skill (65.5%) and level 4a: change in organizational practice (69%) were found to be most prevalent across the studies. Compared to previous systematic reviews on QI training for medical students, there was a significant increase in studies demonstrating Kirkpatrick level 4b: patient benefits (27.6%).
Conclusions:
The trends are consistent with medical school QI training becoming more effective and shifting from an individualized effect to a larger organizational effect. Patient benefits were also observed in a significant number of studies.
Patient or healthcare consumer involvement:
The patients’ needs and interest were represented in the studies reviewed in different ways. Trainees worked on problems critical to patients, utilized real patient data for audit, and learned to work in inter-professional teams to effectively improve patient care.