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Keywords

quality improvement; graduate medical education; quality of health care; clinical competence; curriculum; family medicine; internship and residency; RE-AIM framework

Disciplines

Medical Education

Abstract

Background

Ongoing improvement and evaluation of clinical care are essential to maintaining high standards. The Accreditation Council for Graduate Medical Education (ACGME) requires all accredited family medicine programs to provide quality improvement (QI) education. Given competing educational demands, residency programs must adopt innovative approaches to teaching QI. This article describes an individualized approach to QI education that we implemented in our family medicine residency program and the outcome of its evaluation.

Methods

Guided by a logic model and evaluated using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, this quasi-experimental 1-group pre-test-post-test study (July 2022-June 2023) involved all second-year family medicine residents during a protected QI month. Residents participated in a 1-on-1 session with a QI expert, completed a 10-item baseline knowledge survey, received 4 weekly mentoring meetings to develop a QI charter to address resident-selected quality gap, and completed an online QI module. Knowledge was reassessed at the month’s end, and an end-of-year survey evaluated perceptions and sustainability.

Results

The program achieved 100% reach with the participation of all 12 residents. Knowledge scores improved from 6.25 (±2.2) to 9.0 (±0.95) out of 10 (P < .001). Adoption was high, with all residents completing the module and a QI charter; implementation fidelity was 100%. Ten residents (83%) completed the end-of-year survey, unanimously reporting improved understanding of QI and confidence to lead future projects.

Conclusion

An individualized mentoring approach to QI education was feasible and effective, enhancing resident knowledge and readiness to design targeted improvement initiatives.

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