Outcomes of a Longitudinal Quality Improvement and Patient Safety Preclerkship Curriculum

Acad Med. 2019 Dec;94(12):1980-1987. doi: 10.1097/ACM.0000000000002898.

Abstract

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.

Publication types

  • Evaluation Study

MeSH terms

  • Attitude of Health Personnel
  • Clinical Clerkship*
  • Clinical Competence / standards*
  • Curriculum / standards*
  • Education, Medical, Undergraduate / methods*
  • Education, Medical, Undergraduate / standards
  • Education, Medical, Undergraduate / statistics & numerical data
  • Humans
  • Longitudinal Studies
  • Patient Safety / standards*
  • Program Evaluation
  • Quality Improvement / statistics & numerical data*
  • Rhode Island
  • Students, Medical / psychology*