title: Educating fellows in practice-based learning and improvement and systems-based practice: The value of quality improvement in clinical practice.
abstract: BACKGROUND
  In 1999, the Accreditation Council for Graduate Medical Education identified 6 general competencies in which all residents must receive training. In the decade since these requirements went into effect, practice-based learning and improvement (PBLI) and systems-based practice (SBP) have proven to be the most challenging competencies to teach and assess. Because PBLI and SBP both are related to quality improvement (QI) principles and processes, we developed a QI-based curriculum to teach these competencies to our fellows.
  
  
  METHODS
  This experiential curriculum engaged our fellows in our neonatal intensive care unit's (NICU's) structured QI process. After identifying specific patient outcomes in need of improvement, our fellows applied validated QI methods to develop evidence-based treatment protocols for our neonatal intensive care unit.
  
  
  RESULTS
  These projects led to immediate and meaningful improvements in patient care and also afforded our fellows various means by which to demonstrate their competence in PBLI and SBP. Our use of portfolios enabled us to document our fellows' performance in these competencies quite easily and comprehensively.
  
  
  CONCLUSIONS
  Given the clinical and educational structures common to most intensive care unit-based training programs, we believe that a QI-based curriculum such as ours could be adapted by others to teach and assess PBLI and SBP.
authors.affiliation: Division of Neonatal Medicine, Mayo Clinic, Rochester, MN 55905, USA carey.william@mayo.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Carey
authors.forename: Christopher E
authors.initials: CE
authors.lastname: Colby
mesh_terms: D003162:Competency-Based Education / Q000379:methods*; D004521:Educational Measurement; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007396:Internship and Residency; D008910:Minnesota; D010372:Pediatrics / Q000193:education*; D018743:Perinatal Care; D015397:Program Evaluation; D058996:Quality Improvement