Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies.

Leddy R ，Lewis M ，Ackerman S ，Hill J ，Thacker P ，Matheus M ，Tipnis S ，Gordon L ... -  《-》

Radiology Residency Quality Improvement Curriculum: Lessons Learned.

Quality improvement (QI) skills in radiology are required as part of the Accreditation Council for Graduate Medical Education Diagnostic Radiology Milestones competencies. Although feasibility of QI curricula has been demonstrated in radiology before, there are still barriers to widespread implementation. Here, we share our experience with designing the curriculum structure and selecting content. We describe the QI projects that have been performed and discuss lessons learned, including successes, challenges, and future directions. This information is relevant for many radiology programs currently planning to implement or revise existing QI curricula.

Kadom N ，Sloan K ，Gupte G ，Golden L ，Coleman S ，Gupta A ，Lloyd-Baugnon K ，Moses J ... -  《-》

A Structured Quality Improvement Educational Curriculum Increases Surgical Resident Involvement in QI Processes.

Patient safety and quality improvement (QI) processes are vitally important to healthcare systems. Training and experience in QI processes are mandated by the Accreditation Council for Graduate Medical Education (ACGME) for general surgery residents. The execution and efficacy of these training programs in residencies have thus far been inconsistent. The purpose of this study was to assess the effectiveness of our surgical residency's QI educational program. We instituted a formalized QI educational program for all residents in our academic general surgery residency program from 2018 to 2019. The curriculum included didactics, online educational resources, peer-group collaboration, and faculty mentorship. Residents performed a self-assessment survey of their knowledge, skill, and comfort levels with QI processes before and after the program using a 10-point Likert scale. The number of QI projects conducted, presented, and subsequently prepared for publication was enumerated. The ACGME resident survey program results regarding resident involvement in QI processes before and after program implementation were compared. After 1 year of the program, residents demonstrated significant increases in average self-assessed knowledge of QI processes (6.4 vs. 4.0, p < 0.05), knowledge of local QI resources (5.4 vs. 3.3, p < 0.05), and confidence in their ability to develop and implement a QI project (6.3 vs. 3.9, p < 0.05). The average number of QI projects each resident participated in the year preceding the program vs. during the program increased from 0.4 to 1.8 (p < 0.05). Ten of 26 residents (38%) reported no direct involvement in a QI project the preceding year before the QI program implementation, while 26/26 (100%) of residents reported direct involvement in at least 1 QI project during the implementation year. Residency program ACGME survey results regarding resident participation in QI increased from 86% (just below the national average of 87%) before the development of the QI program to 97% after program implementation. Implementation of a formalized, structured quality improvement education program for surgery residents significantly increased residents' participation in QI projects, as well as increasing their confidence in their knowledge and skillset to perform QI processes. The residency program's ACGME resident survey results regarding resident involvement in QI also improved during program implementation.

Schroll R ，Paramesh A ，Guidry C ，Zelhart M ，Killackey M ，Levy S ... -  《-》

Instituting a radiology residency scholarly activity program.

Amrhein TJ ，Tabesh A ，Collins HR ，Gordon LL ，Helpern JA ，Jensen JH ... -  《-》

Incorporating Quality Improvement into Resident Education: Structured Curriculum, Evaluation, and Quality Improvement Projects.

Quality Improvement (QI) is essential for improving health care delivery and is now a required component of neurosurgery residency. However, neither a formal curriculum nor implementation strategies have been established by the Accreditation Council for Graduate Medical Education. We describe our experience with implementing a formal QI curriculum, including structured didactics and resident led group-based QI projects. Course materials and didactics were provided by the Mayo Quality Academy. Participants were required to take a 30-question multiple-choice exam to demonstrate basic proficiency in QI methods following completion of didactic. An anonymous survey also was performed to elicit feedback from course participants. All of the 40 student participants (17 residents) were able to demonstrate basic proficiency in QI methods on a standardized exam upon course completion. Of the 9 attempted QI projects, 7 were completed, with 5 of those resulting in sustained process changes. The majority of participants felt formal training improved confidence in QI processes and was a valuable professional tool for their careers. A formal didactic curriculum and practical application of QI methodologies adds value to resident training. Further, it has the potential to positively impact practice. Consideration should be given to adopting a formal QI curriculum by other neurosurgery departments and perhaps standardization on national level.

Clarke MJ ，Steffens FL ，Mallory GW ，Starr SR ，Porter BL ，Krauss WE ，Dankbar EC ... -  《-》