Outcomes of a Longitudinal Quality Improvement and Patient Safety Preclerkship Curriculum.

Acad Med

L. Dumenco is assistant dean for medical education, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. K. Monteiro is director, Assessment and Evaluation, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. P. George is associate dean for medical education and director, Clinical Curriculum, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. S. Rougas is director, Doctoring Program, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island. R. Dollase is professor emeritus of medical education, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Published: December 2019

Purpose: To evaluate whether quality improvement (QI) and patient safety (PS) training in preclerkship medical education resulted in students' development and retention of knowledge, application-based and perceived skills, and attitudes throughout clerkships.

Method: A longitudinal QI/PS curriculum with multimodal curricular components was implemented in the preclerkship curriculum between 2015 and 2017 at the Warren Alpert Medical School of Brown University, Rhode Island. Assessments were administered at baseline (T1), end of year 1 (T2), Clinical Skills Clerkship (T3), and end of clerkships (T4) in the intervention cohort (n = 97). In 2018, T4 data for this cohort were compared with a prior control cohort (n = 97) at T4.

Results: Results of knowledge-based multiple-choice questions (MCQs) (t[134] = -1.57, P < .001) and application-based skills (t[132] = -8.91, P < .001) demonstrated significant improvement from T1 to T2 (intervention cohort). Assessments of perceived skills showed significant growth from T1 to T2 (t[137] = -23.38, P < .001). Performance on application-based skills significantly improved from T2 to T3 (t[123] = -4.11, P < .001). Compared with the control cohort, the intervention cohort had significantly higher scores on MCQs (t[187.88] = 3.98, P < .001), application-based skills (t[72.69] = 6.40, P < .001), perceived skills (t[106.99] = 5.24, P < .001), and attitudes (t[152] = 5.86, P < .001).

Conclusions: Incorporation of preclerkship QI/PS training resulted in improvements in knowledge, application-based and perceived skills, and attitudes that were retained throughout clerkships.

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http://dx.doi.org/10.1097/ACM.0000000000002898DOI Listing

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