Validation of a method for assessing resident physicians' quality improvement proposals.
BACKGROUND
Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking.


OBJECTIVE
We developed an instrument for assessing resident QI proposals--the Quality Improvement Proposal Assessment Tool (QIPAT-7)-and determined its validity and reliability.


METHODS
QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised.


METHODS
Seven raters used the instrument to assess 45 resident QI proposals.


METHODS
Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach's alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively.


RESULTS
QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach's alpha = 0.87) were high.


CONCLUSIONS
This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.
Leenstra
James L
JL
Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Beckman
Thomas J
TJ
Reed
Darcy A
DA
Mundell
William C
WC
Thomas
Kris G
KG
Krajicek
Bryan J
BJ
Cha
Stephen S
SS
Kolars
Joseph C
JC
McDonald
Furman S
FS
D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards*; D011786:Quality Control