Key Strategies to Publishing Your Quality Improvement Work.

Background: Improving quality and safety is a goal in health care, and sharing quality improvement (QI) work with internal and external audiences is key to spreading knowledge and ideas for change. Peer-reviewed journals are interested in manuscripts reporting QI work.

Methodology: Although QI work is methodologically different from traditionally published research articles, it can be publishable if conducted in a way that is scholarly and well-planned.

Systems and Complexity Thinking to Master Leadership Challenges in Interprofessional Health Professionals Education.

The purpose of this article is to propose that knowledge, understanding, and application of systems and complexity thinking can improve assessment, implementation, and evaluation of interprofessional education (IPE). Using a case story, the authors describe and explain a meta-model of systems and complexity thinking to support leaders in implementing and evaluating IPE initiatives. The meta-model incorporates the use of several important, interrelated frameworks that tackle issues of sense making, systems, and complexity thinking as well as polarity management at different levels of scale in an organization.

From Theory to Practice: The Enacted Curriculum of a Successful Master's Program in Quality Improvement and Leadership.

Introduction: Blended learning has taken on new prominence in the fields of higher and continuing education, especially as programs have shifted in response to teaching in a global pandemic. The faculty at the Jönköping Academy's Masters in Quality Improvement and Leadership program has been offering a blended learning curriculum, based on four core design principles, since 2009. We studied key features of the enacted curriculum to understand conditions that can support an effective blended learning model.

Practical strategies to enhance resident engagement in clinical quality improvement.

Background: Engaging residents in meaningful quality improvement (QI) is difficult. Challenges include competing demands, didactics which lack connection to meaningful work, suboptimal experiential learning, unclear accountability, absence of timely and relevant data, and lack of faculty coaches and role models. Various strategies to address these challenges for engagement have been described, but not as a unified approach.

Application of continuous quality improvement to medical education.

Context: The explicit, intentional and systematic application of continuous quality improvement (QI) in medical education practice and research can improve medical education and help it achieve its goals. Quality improvement and medical education share a foundation centred on learning-experiencing, reflecting, thinking and acting in continuous cycles that spiral to sustained advancement. This suggests that a QI mindset can be brought to bear on various aspects of medical education research and practice.

Building the Bridge to Quality: An Urgent Call to Integrate Quality Improvement and Patient Safety Education With Clinical Care.

Current models of quality improvement and patient safety (QIPS) education are not fully integrated with clinical care delivery, representing a major impediment toward achieving widespread QIPS competency among health professions learners and practitioners. The Royal College of Physicians and Surgeons of Canada organized a 2-day consensus conference in Niagara Falls, Ontario, Canada, called Building the Bridge to Quality, in September 2016. Its goal was to convene an international group of educational and health system leaders, educators, frontline clinicians, learners, and patients to engage in a consensus-building process and generate a list of actionable strategies that individuals and organizations can use to better integrate QIPS education with clinical care.

Exemplary Learning Environments for the Health Professions: A Vision.

In this article, the authors propose a vision for exemplary learning environments in which everyone involved in health professions education and health care collaborates toward optimal health for individuals, populations, and communities. Learning environments in the health professions can be conceptualized as complex adaptive systems, defined as a collection of individual agents whose actions are interconnected and follow a set of shared "simple rules." Using principles from complex adaptive systems as a guiding framework for the proposed vision, the authors postulate that exemplary learning environments will follow four such simple rules: Health care and health professions education share a goal of improving health for individuals, populations, and communities; in exemplary learning environments, learning is work and work is learning; exemplary learning environments recognize that collaboration with integration of diverse perspectives is essential for success; and the organizations and agents in the learning environments learn about themselves and the greater system they are part of in order to achieve continuous improvement and innovation.

Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting.

Problem: Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting.

Approach: From 2008-2012, an iterative, interactive process was used to develop the ECLS model and its core elements--patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement.

The Quality Improvement Knowledge Application Tool Revised (QIKAT-R).

Purpose: Quality improvement (QI) has been part of medical education for over a decade. Assessment of QI learning remains challenging. The Quality Improvement Knowledge Application Tool (QIKAT), developed a decade ago, is widely used despite its subjective nature and inconsistent reliability.

Aligning academic continuing medical education with quality improvement: a model for the 21st century.

The recent health care quality improvement (QI) movement has called for significant changes to the way that health care is delivered and taught in academic medical centers (AMCs). This movement also has affected academic continuing medical education (CME). In January 2011, to better align the CME and QI efforts of AMCs, the Association of American Medical Colleges (AAMC) launched a pilot initiative called Aligning and Educating for Quality (ae4Q).

Results of an effort to integrate quality and safety into medical and nursing school curricula and foster joint learning.

Improvements in health care are slow, in part because doctors and nurses lack skills in quality improvement, patient safety, and interprofessional teamwork. This article reports on the Retooling for Quality and Safety initiative of the Josiah Macy Jr. Foundation and the Institute for Healthcare Improvement, which sought to integrate improvement and patient safety into medical and nursing school curricula.

Expanding educators' medical curriculum tool chest: minute papers as an underutilized option for obtaining immediate feedback.

Background: One barrier to systematically assessing feedback about the content or format of teaching conferences in graduate medical education is the time needed to collect and analyze feedback data. Minute papers, brief surveys designed to obtain feedback in a concise format, have the potential to fill this gap.

Objectives: To assess whether minute papers were a feasible tool for obtaining immediate feedback on resident conferences and to use minute papers, with one added question, to assess the usefulness of changing the format of resident morning report.

Designing education to improve care.

Background: Educators in all health care disciplines are increasingly aware of the importance and value of teaching improvement as an integral part of health professional development. Although faculty and learners can often identify needed changes in the clinical setting, many educators are not sure how to teach the improvement principles and methods needed to achieve and sustain those changes.

Defining And Developing Competency In Qi: Five developmental levels apply to physicians, nurses, and other members of an interprofessional quality improvement (QI) team: novice, advanced beginner, competent, proficient, and expert.

Linking health professional learners and health care workers on action-based improvement teams.

Background And Methods: Medical students, nursing students, and other health care professionals in training were integrated with health care workers on interprofessional quality improvement (QI) teams at our academic health center. Teams received training in QI, accompanied by expert QI mentoring, with dual goals of increasing expertise in improvement while improving care.

Results: Eighty-six learners and health system workers participated in 12 improvement teams in 2 years.

Uncovering differences among health professions trainees exposed to an interprofessional patient safety curriculum.

In response to the Institute of Medicine challenge to improve patient safety and quality of care, an office directing patient safety/quality of care at an academic medical center and faculty from health professions schools collaborated on design, delivery, and evaluation of an interprofessional student curriculum on patient safety, quality, and teamwork. Annually for 6 years, second-year medical students, senior baccalaureate nursing students, second-year masters in health administration students, and junior baccalaureate respiratory therapy students participated. A pre-/postsurvey assessing students' attitudes about quality, safety, and teamwork was developed and modified to reflect course revisions.

Getting it right: educating professionals to work together in improving health and health care.

This paper is based on a lecture given by LAH as the 2nd John Horder lecture at Imperial College, London on 11 April 2006. Dr. Horder has been influential in improving patient outcomes in multiple ways, including his contributions to professional education.

Teaching residents about practice-based learning and improvement.

Background: The Accreditation Council for Graduate Medical Education has endorsed practice-based learning and improvement (PBLI) as a core competency for residents. Health professions educators have sought since the early 1990s to incorporate quality improvement principles, methods, and skills into training programs. A literature review indicates that questions remain regarding how to best train physicians to lead the improvement of patient care.

Problem-based learning outcomes: ten years of experience at the University of Missouri-Columbia School of Medicine.

Purpose: To add to a previous publication from the University of Missouri-Columbia School of Medicine (UMCSOM) on students' improvement in United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores after the implementation of a problem-based learning (PBL) curriculum by studying the performance of ten PBL class cohorts at the UMCSOM.

Method: Characteristics of graduating classes matriculating in both traditional and PBL curricula, 1993-2006, were compared for Medical College Admission Test component scores, undergraduate grade point averages, performance on the USMLE Step 1 and Step 2 exams, faculty contact hours, and residency directors' evaluations of UMCSOM graduates' performance in the first year of residency.

Results: Mean scores of six of the ten comparisons for USMLE Step 1 and six of nine comparisons for USMLE Step 2 are significantly higher (p < .

Changing and sustaining medical students' knowledge, skills, and attitudes about patient safety and medical fallibility.

Purpose: To study the effects of a patient safety and medical fallibility curriculum on second-year medical students at the University of Missouri-Columbia School of Medicine in 2003-2004.

Method: Students completed a knowledge, skills, and attitudes questionnaire before the curriculum, after the final learning experience, and one year later. A 95% confidence interval (CI) for paired differences assessed change over time.

Mr. Young's doctor: how must physicians be prepared for practice?

What will the practice of medicine be like when people use publicly-available performance data to choose their physicians, own their own medical records and therefore exercise more control over medical decision making than has ever been seen in the past? What do these changes mean for the preparation of physicians? The Institute of Medicine has set forth six aims for health care in the United States, that it be safe, effective, patient-centered, timely, efficient and equitable. Achieving this requires new rules for our work in health care and new goals for medical education. The University of Missouri-Columbia School of Medicine has identified eight key characteristics of its graduating students and residents.