Quality Improvement Training in Medical Education

Brown, Allison J.

Quality Improvement Training in Medical Education

dc.contributor.advisor	Kassam, Aliya
dc.contributor.advisor	Hecker, Kent
dc.contributor.author	Brown, Allison J.
dc.contributor.committeemember	Sharma, Nishan
dc.contributor.committeemember	McCaughey, Deirdre
dc.date	2020-06
dc.date.accessioned	2020-05-07T21:08:56Z
dc.date.available	2020-05-07T21:08:56Z
dc.date.issued	2020-05-06
dc.description.abstract	Problem: Training healthcare professionals in Quality Improvement (QI) has been highlighted as a potential strategy to reduce the prevalence of error and harm in healthcare. As a result, various health professions education programs have integrated QI into the competency frameworks that inform the core curriculum, including those used in the training of medical doctors. However, QI has been integrated, emphasized, and taught to medical trainees (i.e., medical students and residents) in a variety of ways across countries, programs, and stages of training. As contemporary medical education increasingly adapts outcomes-oriented, competency-based models of training, medical trainees may be required to demonstrate competency in QI during their training. Method of Study: This research considered how best to train future physicians in QI during their core medical training. First, methods for examining complex social phenomena were analyzed through a thought experiment exploring the methodological intersections of realist inquiry (RI) with structural equation modelling (SEM). Next, a realist synthesis examined the literature for teaching QI at the undergraduate and postgraduate levels of medical training. This generated an explanatory program theory that highlighted common associations between contexts, mechanisms, and outcomes of QI training in undergraduate and postgraduate medical training. Finally, a collective case study of four postgraduate programs at the University of Calgary examined how residents learned about QI during their training using four data sources. The combinations of RI and SEM were re-visited and operationalized as the program theory informed the specification of structural models using the quantitative data in the case study. This resulted in a novel, realist-informed SEM that statistically modelled elements associated with resident self-assessments of QI knowledge, skills, and attitudes. Conclusions: Explicit training in QI might ensure that all physicians enter practice equipped with the fundamental knowledge and skills to not only recognize areas for improvement, but implement sustainable solutions that improve the quality and safety of care. The conscientious design of QI curricula in the core medical curriculum that considers integrating features commonly associated with successful QI curricula may be beneficial to optimize training in this domain, and ultimately, catalyze the development of QI competencies amongst future physicians.	en_US
dc.identifier.citation	Brown, A. J. (2020). Quality Improvement Training in Medical Education (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.	en_US
dc.identifier.doi	http://dx.doi.org/10.11575/PRISM/37807
dc.identifier.uri	http://hdl.handle.net/1880/112004
dc.language.iso	eng	en_US
dc.publisher.faculty	Cumming School of Medicine	en_US
dc.publisher.institution	University of Calgary	en
dc.rights	University of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.	en_US
dc.subject	medical education	en_US
dc.subject	quality improvement	en_US
dc.subject.classification	Education	en_US
dc.subject.classification	Medicine and Surgery	en_US
dc.title	Quality Improvement Training in Medical Education	en_US
dc.type	doctoral thesis	en_US
thesis.degree.discipline	Medicine – Community Health Sciences	en_US
thesis.degree.grantor	University of Calgary	en_US
thesis.degree.name	Doctor of Philosophy (PhD)	en_US
ucalgary.item.requestcopy	true	en_US