title: Development and participant assessment of a practical quality improvement educational initiative for surgical residents.
abstract: BACKGROUND
  As patient-safety and quality efforts spread throughout health care, the need for physician involvement is critical, yet structured training programs during surgical residency are still uncommon. Our objective was to develop an extended quality-improvement curriculum for surgical residents that included formal didactics and structured practical experience.
  
  
  METHODS
  Surgical trainees completed an 8-hour didactic program in quality-improvement methodology at the start of PGY3. Small teams developed practical quality-improvement projects based on needs identified during clinical experience. With the assistance of the hospital's process-improvement team and surgical faculty, residents worked through their selected projects during the following year. Residents were anonymously surveyed after their participation to assess the experience.
  
  
  RESULTS
  During the first 3 years of the program, 17 residents participated, with 100% survey completion. Seven quality-improvement projects were developed, with 57% completing all DMAIC (Define, Measure, Analyze, Improve, Control) phases. Initial projects involved issues of clinical efficiency and later projects increasingly focused on clinical care questions. Residents found the experience educationally important (65%) and believed they were well equipped to lead similar initiatives in the future (70%). Based on feedback, the timeline was expanded from 12 to 24 months and changed to start in PGY2.
  
  
  CONCLUSIONS
  Developing an extended curriculum using both didactic sessions and applied projects to teach residents the theory and implementation of quality improvement is possible and effective. It addresses the ACGME competencies of practice-based improvement and learning and systems-based practice. Our iterative experience during the past 3 years can serve as a guide for other programs.
authors.affiliation: Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
authors.forename: Morgan M
authors.initials: MM
authors.lastname: Sellers
authors.forename: Kristi
authors.initials: K
authors.lastname: Hanson
authors.forename: Mary
authors.initials: M
authors.lastname: Schuller
authors.forename: Karen
authors.initials: K
authors.lastname: Sherman
authors.forename: Rachel R
authors.initials: RR
authors.lastname: Kelz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Fryer
authors.forename: Debra
authors.initials: D
authors.lastname: DaRosa
authors.forename: Karl Y
authors.initials: KY
authors.lastname: Bilimoria
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D010820:Physicians / Q000592:standards*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D013043:Specialties, Surgical / Q000193:education*; D014481:United States