Developing a Practice-Based Learning and Improvement Quality Improvement (QI) Systems Impact Assessment Questionnaire

NCT00754377 | Completed Results

• 1 other identifier: SHP 08-194
• Study Type: observational
• Target: 92
• Locations: 1 country
• Sites: 1

Brief Summary

The Accreditation Council for Graduate Medical Education (ACGME) acknowledged the changing needs of physicians in training when it endorsed practice-based learning and improvement (PBLI) -- a competency that is typically omitted from medical curriculum. The goal is to have residents competent to investigate and evaluate their own patient care practices, integrate scientific evidence and be able to improve their practices. Available assessment tools do not adequately address all of the components of PBLI and few assessment tools attempt to capture the residents' ability to develop and implement clinically-based Continuous Quality Improvement (CQI) projects that involve the practice setting. Curriculums without such foci miss the importance of system perspectives and opportunities for interprofessional team development. Our aim is to evaluate preliminary data on the curriculum we developed to address the gaps, to develop an assessment tool, and to provide methods for assessing the sustainability of system projects. The key component of the curriculum is the integration of system quality improvement projects. PBLI curriculum was offered on alternate rotations. Preliminary data is available from 6 PBLI QI Systems Curriculum blocks (n=50) and 5 comparison blocks (n=42). Data includes closed- and open-ended questions designed to assess resident PBLI application skills, the notes and presentation slides for the residents' presentation.

Conditions

Quality Improvement

Keywords

Education; Program Evaluation; Quality of Health Care; Medical Residents

Outcome Measures

Primary Outcomes (1)

• Beliefs About Ability to Implement a CQI Project

  Residents' belief about their ability to implement a CQI project was measured using a single efficacy item (values ranged from 1, strongly disagree, to 5, strongly agree). The item is from the Systems Quality Improvement Training and Assessment Tool. Differences (post minus pre) in this belief item were looked at with positive and higher difference values reflecting more positive change/increase in belief.

  1 month

Secondary Outcomes (1)

• Change in Knowledge Scores About Quality Improvement

  1 Month

Study Arms (2)

PBLI Curriculum group

To evaluate preliminary data on a PBLI curriculum grounded on QI system projects.

Other: PBLI Curriculum

Comparison group

Received a different curriculum.

Interventions

PBLI Curriculum OTHER

PBLI curriculum was offered on alternate rotations

PBLI Curriculum group

Eligibility Criteria

• Age: 25 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Internal Medicine residents

You may not qualify if:

• None, the residents from 2004 that did not complete a 4 week ambulatory block and residents participating in ambulatory block 7 and 13 were excluded from the study previously Institutional Review Board (IRB) approved and exempted study. Blocks 7 and 13 are not structured to permit teaching.

Sponsors & Collaborators

• US Department of Veterans Affairs: lead

Study Sites (1)

Louis Stokes VA Medical Center, Cleveland, OH

Cleveland, Ohio, 44106, United States

Location

Related Publications (3)

• Stulberg JJ, Delaney CP, Neuhauser DV, Aron DC, Fu P, Koroukian SM. Adherence to surgical care improvement project measures and the association with postoperative infections. JAMA. 2010 Jun 23;303(24):2479-85. doi: 10.1001/jama.2010.841.

  PMID: 20571014 RESULT

• Lawrence RH, Tomolo AM. Development and preliminary evaluation of a practice-based learning and improvement tool for assessing resident competence and guiding curriculum development. J Grad Med Educ. 2011 Mar;3(1):41-8. doi: 10.4300/JGME-D-10-00102.1.

  PMID: 22379522 RESULT

• Tomolo AM, Lawrence RH, Watts B, Augustine S, Aron DC, Singh MK. Pilot study evaluating a practice-based learning and improvement curriculum focusing on the development of system-level quality improvement skills. J Grad Med Educ. 2011 Mar;3(1):49-58. doi: 10.4300/JGME-D-10-00104.1.

  PMID: 22379523 RESULT

Limitations and Caveats

While necessary limitations for initial assessment tool development, concerns will be addressed in the multi-site trial of the curriculum, including assessment of the training manual and codebooks that were developed during this project.

Results Point of Contact

• Title: Dr. David Aron
• Organization: Louis Stokes VA Medical Center

david.aron@va.gov

(216) 791-2300

Study Officials

• David C Aron, MD MS

  Louis Stokes VA Medical Center, Cleveland, OH

  PRINCIPAL INVESTIGATOR

Publication Agreements

• PI is Sponsor Employee: Yes
• Restrictive Agreement: No

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: FED
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 16, 2008
• First Posted: September 18, 2008
• Study Start: January 1, 2008
• Primary Completion: July 1, 2008
• Study Completion: December 1, 2011
• Last Updated: May 12, 2015
• Results First Posted: November 14, 2014

Record last verified: 2015-04

Locations

US (1)