Janelle Gomez, BS
Research Coordinator, Physical Medicine and Rehabilitation
Penn State Health and College of Medicine
Hershey, Pennsylvania, United States
Prateek Grover, MD
Associate Professor of PM&R and Biomedical Engineering (Adjunct)
Penn State University College of Medicine and University
Hershey, Pennsylvania, United States
While PM&R Quality Improvement (QI) education is an ACGME requirement, residents level of knowledge, comfort, and application varies. Known barriers include time, mentorship, interest, and curriculum design. To make QI learning easier and quicker, the authors developed a novel QI toolkit using concepts from IHI Model for improvement, Six-Sigma, and AHRQ QI measures that also enables structured QI project performance. The objective of this study was to teach PM&R residents QI using this QI toolkit in a longitudinal experiential curriculum format over 1 year, and to evaluate resident changes in knowledge, affect, and performance regarding QI.
Design:
QI curriculum components included: a) three 2-hour didactic and experiential sessions over academic year 2023-24 using the QI toolkit (5 worksheets,7 QI tools), b) weekly QI rounding, and c) resident QI champion position establishment.
Changes in resident QI knowledge, affect, and performance were assessed as part of an IRB Non-Human Subjects Research study. A 10-question 1-5 (not at all-a lot) Likert-scale survey was designed using COM-B (capability, opportunity, motivation, behavior) and PER (predisposing, enabling, and reinforcing) constructs and administered at the end of each didactic session to all residents in attendance (maximum n=12).
Results:
All questions received top box scores (4:very much, 5:a lot) for sessions 1(n=9), 2(n=9), and 3(n=10). Scores improved across sessions 1-3 from cognitive (difference between QI / educational curriculum / research projects, QI tools, QI publications / presentation themes) to affective (QI work is useful, easier to perform, will continue QI work post-residency) and affective-psychomotor domains (improvement in QI performance skills, presentation skills, publication skills).
Conclusions:
Based upon survey results, informal feedback to faculty, and QI approach utilization in practice, the QI curriculum demonstrated progressive learning with QI. The QI toolkit is being refined and will be utilized to teach QI to other specialties in a weeklong workshop format in Spring 2025.
