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Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects
To create meaningful quality improvement (QI) curricula for graduate medical education (GME) trainees, institutions strive to improve coordination of QI curricula with hospital improvement infrastructure. We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed...
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| Published in: | Journal of graduate medical education 2020-06, Vol.12 (3), p.320-326 |
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| Main Authors: | , , , , , , |
| Format: | Article |
| Language: | English |
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| container_end_page | 326 |
| container_issue | 3 |
| container_start_page | 320 |
| container_title | Journal of graduate medical education |
| container_volume | 12 |
| creator | Durstenfeld, Matthew S Statman, Scott Carney, Kerrilynn Cohan, Brigette Bosworth, Brian Hauck, Kevin Dikman, Andrew |
| description | To create meaningful quality improvement (QI) curricula for graduate medical education (GME) trainees, institutions strive to improve coordination of QI curricula with hospital improvement infrastructure.
We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed curricular effectiveness.
We designed a 2-week required curriculum for internal medicine residents at a large academic program. After participating in basic skills workshops, trainees developed QI/VBM project ideas with faculty and nonclinical support and pitched them to hospital leaders at the end of the rotation. Pre-post and 1-year follow-up surveys were conducted for residents to self-assess knowledge, attitudes, and skills, participation in QI/VBM projects, and career intentions. We tracked QI/VBM project implementation.
In the first 2 years (2017-2018), 92 trainees participated, and 71 of 76 (93%) recommended the curriculum. Surveys (76 of 92, 83%) show improvement in our learning objectives (12%-60% pre to 62%-97% post;
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| doi_str_mv | 10.4300/JGME-D-19-00421.1 |
| format | article |
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We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed curricular effectiveness.
We designed a 2-week required curriculum for internal medicine residents at a large academic program. After participating in basic skills workshops, trainees developed QI/VBM project ideas with faculty and nonclinical support and pitched them to hospital leaders at the end of the rotation. Pre-post and 1-year follow-up surveys were conducted for residents to self-assess knowledge, attitudes, and skills, participation in QI/VBM projects, and career intentions. We tracked QI/VBM project implementation.
In the first 2 years (2017-2018), 92 trainees participated, and 71 of 76 (93%) recommended the curriculum. Surveys (76 of 92, 83%) show improvement in our learning objectives (12%-60% pre to 62%-97% post;
< .001 for all; Cohen's d effect size 0.7-1.2), which are sustained at 1-year follow-up (57%-95%;
< .01). Four of 19 projects have been implemented. At 1 year, 95% of residents had presented a quality/value poster presentation, 44% were involved in QI/VBM beyond required rotations, and 26% plan to pursue careers focused on improving quality, safety, or value.
Our project-based curriculum culminating in a project pitch to hospital leadership was acceptable to GME trainees, improved self-assessed skills sustained at 1 year, and resulted in successfully implemented QI/VBM projects.</description><identifier>ISSN: 1949-8349</identifier><identifier>EISSN: 1949-8357</identifier><identifier>DOI: 10.4300/JGME-D-19-00421.1</identifier><identifier>PMID: 32595852</identifier><language>eng</language><publisher>United States: The Accreditation Council for Graduate Medical Education</publisher><subject>Career Choice ; Curriculum ; Delivery of Health Care - economics ; Education, Medical, Graduate - methods ; Educational Innovation ; Faculty, Medical ; Humans ; Internship and Residency ; New York ; Quality Improvement ; Quality of Health Care - standards ; Surveys and Questionnaires</subject><ispartof>Journal of graduate medical education, 2020-06, Vol.12 (3), p.320-326</ispartof><rights>Accreditation Council for Graduate Medical Education 2020.</rights><rights>Accreditation Council for Graduate Medical Education 2020 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3141-5cef955510b27e5f8948f26c4a7091d84df9a79cb18d42a3dd26d187baebdef43</citedby><cites>FETCH-LOGICAL-c3141-5cef955510b27e5f8948f26c4a7091d84df9a79cb18d42a3dd26d187baebdef43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301934/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301934/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32595852$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Durstenfeld, Matthew S</creatorcontrib><creatorcontrib>Statman, Scott</creatorcontrib><creatorcontrib>Carney, Kerrilynn</creatorcontrib><creatorcontrib>Cohan, Brigette</creatorcontrib><creatorcontrib>Bosworth, Brian</creatorcontrib><creatorcontrib>Hauck, Kevin</creatorcontrib><creatorcontrib>Dikman, Andrew</creatorcontrib><title>Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects</title><title>Journal of graduate medical education</title><addtitle>J Grad Med Educ</addtitle><description>To create meaningful quality improvement (QI) curricula for graduate medical education (GME) trainees, institutions strive to improve coordination of QI curricula with hospital improvement infrastructure.
We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed curricular effectiveness.
We designed a 2-week required curriculum for internal medicine residents at a large academic program. After participating in basic skills workshops, trainees developed QI/VBM project ideas with faculty and nonclinical support and pitched them to hospital leaders at the end of the rotation. Pre-post and 1-year follow-up surveys were conducted for residents to self-assess knowledge, attitudes, and skills, participation in QI/VBM projects, and career intentions. We tracked QI/VBM project implementation.
In the first 2 years (2017-2018), 92 trainees participated, and 71 of 76 (93%) recommended the curriculum. Surveys (76 of 92, 83%) show improvement in our learning objectives (12%-60% pre to 62%-97% post;
< .001 for all; Cohen's d effect size 0.7-1.2), which are sustained at 1-year follow-up (57%-95%;
< .01). Four of 19 projects have been implemented. At 1 year, 95% of residents had presented a quality/value poster presentation, 44% were involved in QI/VBM beyond required rotations, and 26% plan to pursue careers focused on improving quality, safety, or value.
Our project-based curriculum culminating in a project pitch to hospital leadership was acceptable to GME trainees, improved self-assessed skills sustained at 1 year, and resulted in successfully implemented QI/VBM projects.</description><subject>Career Choice</subject><subject>Curriculum</subject><subject>Delivery of Health Care - economics</subject><subject>Education, Medical, Graduate - methods</subject><subject>Educational Innovation</subject><subject>Faculty, Medical</subject><subject>Humans</subject><subject>Internship and Residency</subject><subject>New York</subject><subject>Quality Improvement</subject><subject>Quality of Health Care - standards</subject><subject>Surveys and Questionnaires</subject><issn>1949-8349</issn><issn>1949-8357</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNpVUVtPFTEQboxECPADfDF99KXY6YXd-mCigAiBiHLUx6bbzp4t7uXQ7kL49-4BPNF5mcnMd5nkI-Q18AMlOX93fnp5wo4ZGMa5EnAAL8gOGGVYKXXxcjMrs032c77hc0kjShCvyLYU2uhSix1yf30fuy72S_orjg29blz6nd_TBTrfrLffMceA_ZjpT9dOyD65jIFeYog-9khdH-i3ybVxfKBn3SoNd9jNaLpo0jAtmw2dXcXRNzPzKg036Me8R7Zq12bcf-675Mfnk8XRF3bx9fTs6OMF8xIUMO2xNlpr4JUoUNelUWUtDr1yBTcQShVq4wrjKyiDEk6GIA4DlEXlsApYK7lLPjzprqaqw-DnX5Jr7SrFzqUHO7ho_7_0sbHL4c4WkoORa4G3zwJpuJ0wj7aL2WPbuh6HKVuhZjthDNczFJ6gPg05J6w3NsDtOjO7zsweWzD2MTMLM-fNv_9tGH8Tkn8A97OVQQ</recordid><startdate>202006</startdate><enddate>202006</enddate><creator>Durstenfeld, Matthew S</creator><creator>Statman, Scott</creator><creator>Carney, Kerrilynn</creator><creator>Cohan, Brigette</creator><creator>Bosworth, Brian</creator><creator>Hauck, Kevin</creator><creator>Dikman, Andrew</creator><general>The Accreditation Council for Graduate Medical Education</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>202006</creationdate><title>Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects</title><author>Durstenfeld, Matthew S ; Statman, Scott ; Carney, Kerrilynn ; Cohan, Brigette ; Bosworth, Brian ; Hauck, Kevin ; Dikman, Andrew</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3141-5cef955510b27e5f8948f26c4a7091d84df9a79cb18d42a3dd26d187baebdef43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Career Choice</topic><topic>Curriculum</topic><topic>Delivery of Health Care - economics</topic><topic>Education, Medical, Graduate - methods</topic><topic>Educational Innovation</topic><topic>Faculty, Medical</topic><topic>Humans</topic><topic>Internship and Residency</topic><topic>New York</topic><topic>Quality Improvement</topic><topic>Quality of Health Care - standards</topic><topic>Surveys and Questionnaires</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Durstenfeld, Matthew S</creatorcontrib><creatorcontrib>Statman, Scott</creatorcontrib><creatorcontrib>Carney, Kerrilynn</creatorcontrib><creatorcontrib>Cohan, Brigette</creatorcontrib><creatorcontrib>Bosworth, Brian</creatorcontrib><creatorcontrib>Hauck, Kevin</creatorcontrib><creatorcontrib>Dikman, Andrew</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of graduate medical education</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Durstenfeld, Matthew S</au><au>Statman, Scott</au><au>Carney, Kerrilynn</au><au>Cohan, Brigette</au><au>Bosworth, Brian</au><au>Hauck, Kevin</au><au>Dikman, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects</atitle><jtitle>Journal of graduate medical education</jtitle><addtitle>J Grad Med Educ</addtitle><date>2020-06</date><risdate>2020</risdate><volume>12</volume><issue>3</issue><spage>320</spage><epage>326</epage><pages>320-326</pages><issn>1949-8349</issn><eissn>1949-8357</eissn><abstract>To create meaningful quality improvement (QI) curricula for graduate medical education (GME) trainees, institutions strive to improve coordination of QI curricula with hospital improvement infrastructure.
We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed curricular effectiveness.
We designed a 2-week required curriculum for internal medicine residents at a large academic program. After participating in basic skills workshops, trainees developed QI/VBM project ideas with faculty and nonclinical support and pitched them to hospital leaders at the end of the rotation. Pre-post and 1-year follow-up surveys were conducted for residents to self-assess knowledge, attitudes, and skills, participation in QI/VBM projects, and career intentions. We tracked QI/VBM project implementation.
In the first 2 years (2017-2018), 92 trainees participated, and 71 of 76 (93%) recommended the curriculum. Surveys (76 of 92, 83%) show improvement in our learning objectives (12%-60% pre to 62%-97% post;
< .001 for all; Cohen's d effect size 0.7-1.2), which are sustained at 1-year follow-up (57%-95%;
< .01). Four of 19 projects have been implemented. At 1 year, 95% of residents had presented a quality/value poster presentation, 44% were involved in QI/VBM beyond required rotations, and 26% plan to pursue careers focused on improving quality, safety, or value.
Our project-based curriculum culminating in a project pitch to hospital leadership was acceptable to GME trainees, improved self-assessed skills sustained at 1 year, and resulted in successfully implemented QI/VBM projects.</abstract><cop>United States</cop><pub>The Accreditation Council for Graduate Medical Education</pub><pmid>32595852</pmid><doi>10.4300/JGME-D-19-00421.1</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of graduate medical education, 2020-06, Vol.12 (3), p.320-326 |
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| language | eng |
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| source | PubMed Central |
| subjects | Career Choice Curriculum Delivery of Health Care - economics Education, Medical, Graduate - methods Educational Innovation Faculty, Medical Humans Internship and Residency New York Quality Improvement Quality of Health Care - standards Surveys and Questionnaires |
| title | Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects |
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