Jamie B. Warren,Oregon Health & Science University,Portland,OR
Competency-based medical education and Entrustable Professional Activities (EPAs) have tasked undergraduate medical educators with teaching and assessing students in domains such as "Practice-based learning and improvement (PBLI)" and "Systems-based practice (SBP),"1 and activites including contribution to a culture of safety and improvement (EPA 13) and interprofessional collaboration (EPA 9).2 This necessitates innovative curricular changes in undergraduate medical education (UME). The Department of Pediatrics at Oregon Health & Science University has a robust quality improvement (QI) infrastructure, providing a rich environment to incorporate students into pediatric-based interprofessional QI projects.
This elective was created to provide knowledge on the fundamentals of QI and experience with QI and interprofessional teamwork in clinical settings. The curriculum specifically assesses aspects of competency domains PBLI and SBP, and EPAs 9 and 13.
Students earned their Basic Certificate and demonstrated knowledge on a patient safety quiz. Students showed understanding of QI skills and qualities of QI teams during small-group discussions and report-outs. Structured evaluation from participants in individual and group formats provided overwhelmingly positive feedback with opportunities for improvement.Discussion:
We offer the course twice yearly and have completed our first four-week elective. Students were able to fully participate in and practice QI—an aspect of medical practice not always available to students. Projects were all interprofessional in nature and included antibiotic stewardship in the neonatal intensive care unit, breast feeding in certain neonatal populations, patient flow in outpatient pediatric clinics, and introduction of needle-free injections in the outpatient pediatric lab. This course could easily be adapted at any medical school, provided the opportunity for involvement in clinically-based QI projects exists. The rotational aspect of the clinical years in UME provides a challenge in that most QI work spans longer than one month; however, students have remained involved with projects beyond the elective as time and interest has allowed.