Education Research: A novel resident-driven neurology quality improvement curriculum

Abstract

ObjectiveTo describe and assess the effectiveness of a neurology resident quality improvement curriculum focused on development of practical skills and project experience.MethodsWe designed and implemented a quality improvement curriculum composed of (1) a workshop series and (2) monthly resident-led Morbidity, Mortality, & Improvement conferences focused on case analysis and project development. Surveys were administered precurriculum and 18 months postcurriculum to assess the effect on self-assessed confidence with quality improvement skills, attitudes, and project participation. Scholarship in the form of posters, presentations, and manuscripts was tracked during the course of the study.ResultsPrecurriculum, 83% of neurology residents felt that instruction in quality improvement was important, but most rated their confidence level with various skills as low. Following implementation of the curriculum, residents were significantly more confident in analyzing a patient case (odds ratio, 95% confidence interval) (2.4, 1.9–3.1), proposing system changes (3.1, 2.3–3.9), writing a problem statement (9.9, 6.2–13.5), studying a process (3.1, 2.3–3.8), identifying resources (3.1, 2.3–3.8), identifying appropriate measures (2.5, 1.9–3.0), collaborating with other providers to make improvements (4.9, 3.5–6.4), and making changes in a system (3.1, 2.3–3.8). Project participation increased from the precurriculum baseline (7/18, 39%) to the postcurriculum period (17/22, 77%; p = 0.023). One hundred percent of residents surveyed rated the curriculum positively.ConclusionsOur multifaceted curriculum was associated with increased resident confidence with quality improvement skills and increased participation in improvement projects. With adequate faculty mentorship, this curriculum represents a novel template for preparing neurology residents for meeting the expectations of improvement in practice and offers scholarship opportunities.

Neurology Morbidity and Mortality Conferences and Quality Improvement: Single-Center Experience and National Survey

“…Our study builds upon a single-center report describing the evolution of M&Ms after implementation of a novel quality improvement curriculum. 22 Our national survey results suggest that many other Neurology departments are beginning to use quality-improvement in M&Ms Our data shows that many neurology departments conduct M&Ms; however, there is variability in their structure, frequency, attendance, and adoption of quality/safety methodology. Between 50% and 70% of departments reported implementation of selected quality and safety "best practices" including peer review protection, just culture algorithm, root cause analysis, multidisciplinary participation and guideline creation.…”

Customised knowledge-sharing platform to foster resident quality improvement activities, tracking and scholarship

“…To address gaps in QI training, novel curricula have educated residents in QI methods, increasing knowledge of, confidence about and participation in QI work 5–10. Other barriers, however, are not addressed solely by education, necessitating a more comprehensive approach.…”

“…To address gaps in QI training, novel curricula have educated residents in QI methods, increasing knowledge of, confidence about and participation in QI work. [5][6][7][8][9][10] Other barriers, however, are not addressed solely by education, necessitating a more comprehensive approach. Programmes highlighting successful resident QI work, such as end-of-year celebrations and guidance for including QI in a curriculum vitae, 11 may improve resident engagement.…”