title: Validation of a method for assessing resident physicians' quality improvement proposals.
abstract: 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.
authors.affiliation: Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Leenstra
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Beckman
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Reed
authors.forename: William C
authors.initials: WC
authors.lastname: Mundell
authors.forename: Kris G
authors.initials: KG
authors.lastname: Thomas
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Krajicek
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Kolars
authors.forename: Furman S
authors.initials: FS
authors.lastname: McDonald
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards*; D011786:Quality Control