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Shaping a Culture for Continuous Quality Improvement in Undergraduate Medical Education.

ABSTRACT: PURPOSE:This study sought to identify key features of an organizational quality culture and explore how these features contribute to continuous quality improvement of undergraduate medical education. METHOD:Between July and December 2018, researchers from Maastricht University in the Netherlands conducted a multicenter focus group study among 6 education quality advisory committees. Participants were 22 faculty and 18 student representatives affiliated with 6 medical schools in the Netherlands. The group interviews focused on quality culture characteristics in relation to optimizing educational development, implementation, evaluation, and (further) improvement. Template analysis, a stepwise type of thematic analysis, was applied to analyze the data. RESULTS:Five main themes resembling quality culture constituents to continuous educational improvement were identified: (1) fostering an open systems perspective, (2) involving stakeholders in educational (re)design, (3) valuing teaching and learning, (4) navigating between ownership and accountability, and (5) building on integrative leadership to overcome tensions inherent in the first 4 themes. A supportive communication climate (which can be fueled by the organization's leaders) contributes to and is integrated within the first 4 themes. CONCLUSIONS:The results call for a shift away from static quality management approaches with an emphasis on control and accountability toward more flexible, development-oriented approaches focusing on the 5 themes of a culture for continuous quality improvement. The study provides new insights in the link between theory and practice of continuous quality improvement. Specifically, in addition to quality management systems and structures, faculty's professional autonomy, collaboration with peers and students, and the valuing of teaching and learning need to be amplified.

SUBMITTER: Bendermacher GWG

PROVIDER: S-EPMC7678663 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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Shaping a Culture for Continuous Quality Improvement in Undergraduate Medical Education.

Bendermacher Guy W G GWG De Grave Willem S WS Wolfhagen Ineke H A P IHAP Dolmans Diana H J M DHJM Oude Egbrink Mirjam G A MGA

Academic medicine : journal of the Association of American Medical Colleges 20201201 12

<h4>Purpose</h4>This study sought to identify key features of an organizational quality culture and explore how these features contribute to continuous quality improvement of undergraduate medical education.<h4>Method</h4>Between July and December 2018, researchers from Maastricht University in the Netherlands conducted a multicenter focus group study among 6 education quality advisory committees. Participants were 22 faculty and 18 student representatives affiliated with 6 medical schools in th ...[more]

PMID: 32287081

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Project description:BackgroundQuality improvement (QI) is an essential component of modern clinical practice. Front-line professionals offer valuable perspectives on areas for improvement and are motivated to deliver change. In the UK, all junior doctors are expected to participate in QI in order to advance to the next stage of their training. However, UK undergraduates receive no standardized training in QI methods. This is perpetuated within medical schools by a lack of teaching capacity and competing priorities, and may lead to tokenistic engagement with future QI projects.MethodsWe describe a near-peer teaching programme designed to introduce students to QI methods. This pilot study was conceived and delivered in full by junior doctors and used existing resources to ensure high quality teaching content. 111 fifth-year medical students from the University of Cambridge were taught in interactive, participative workshops that encourage them to develop their own QI change ideas and projects. Core topics included the model for improvement, driver diagrams, stakeholder engagement, measurement for improvement and analysing and presenting data. Students completed surveys before and immediately after this intervention to assess their understanding of and confidence in utilizing QI methods. Questionnaires were also completed by junior doctor tutors.ResultsAnalysis of questionnaires completed before and immediately after the intervention revealed statistically significant improvements in students' self-reported understanding of QI (p <?0.05) and confidence in applying techniques to their own work (p?<?0.05). Students expressed a preference for QI teaching delivered by junior doctors, citing a relaxed learning environment and greater relevance to their stage of training. Tutors reported increased confidence in using QI techniques and a greater willingness to engage with QI in future.ConclusionsIn this single-centre study, near-peer teaching produced significant improvements in students' self-reported understanding of QI and confidence in applying QI methods. Near-peer teaching may constitute a sustainable means of teaching essential QI skills at undergraduate level. Future work must evaluate objective measures of student engagement with and competence in conducting QI.

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Dataset Information

Shaping a Culture for Continuous Quality Improvement in Undergraduate Medical Education.

Publications

Shaping a Culture for Continuous Quality Improvement in Undergraduate Medical Education.

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