A Framework for Teaching Medical Students and Residents about Practice-based Learning and Improvement, Synthesized from a Literature Review

Abstract

Teaching the knowledge and skills of practice-based learning and improvement to medical students and residents is a necessary and important foundation for improving patient care. The authors present a framework of learning objectives-informed by the literature and synthesized by the expert panel-to assist educational leaders when integrating these objectives into a curriculum. This framework serves as a blueprint to bridge the gap between current knowledge and future practice needs.

Health Professions Education

“…Teaching systembased practice and practice-based learning and improvement has been especially daunting for faculty without experience in quality improvement. 8 For these reasons, and acknowledging the dependency of quality medical education on the presence of quality medical care and improvement, we introduce a formative approach to the presentation of the core competencies to residents, which in turn is having an effect on the faculty and their patient care.…”

Tracking Patient Encounters and Clinical Skills to Determine Competency in Ambulatory Care Advanced Pharmacy Practice Experiences

“…22 However, the specific number of patients seen and skills performed for competency is only one factor to consider when determining competency in ambulatory care practice, which begs the question of whether competence should be the educational goal for pharmacy APPE students. If the application of the Dreyfus model in medicine regards a graduating medical resident as competent, 14,16,17 then applying this standard to a pharmacy student may be unreasonable.…”

“…12 Since its initial publication, the Dreyfus model has been adapted for professional education and applied in medicine, nursing, and public health. [12][13][14][15][16][17][18] It was used by the Accreditation Council for Graduate Medical Education (ACGME) in defining competencies and milestones reached for graduate medical education (eg, residency programs). 19 Several articles from medicine apply the Dreyfus model to medical education by placing medical students in the "novice" to "advanced beginner" stage, and a senior graduating resident in the "competent" stage.…”

“…Higher stages of "proficient" and "expert" are not met until later in an individual's career. 14,16,17 Based on the significant work in medical training, it is likely the Dreyfus model can be applied to pharmacy. Because the model has not been widely applied in pharmacy education, it is not yet clear what the expected stage of learning should be for APPE students.…”

Piloting a patient safety and quality improvement co-curriculum

“…In 2003, Ogrinc et al performed a literature review and developed recommendations for teaching practice-based learning and QI. While the authors’ focus was on medical students rather than residents, their recommendations highlighted the importance of instruction on QI, change theory, and the link between quality and cost throughout the student’s training, as well as the need for well-defined and time-limited experiential activities imbedded within didactic instruction [3]. There is a paucity of literature describing curricular implementations to train faculty and residents how to effectively conduct PS/QI projects.…”