Quality in-training initiative--a solution to the need for education in quality improvement: results from a survey of program directors.
BACKGROUND
The Next Accreditation System and the Clinical Learning Environment Review Program will emphasize practice-based learning and improvement and systems-based practice. We present the results of a survey of general surgery program directors to characterize the current state of quality improvement in graduate surgical education and introduce the Quality In-Training Initiative (QITI).


METHODS
In 2012, a 20-item survey was distributed to 118 surgical residency program directors from ACS NSQIP-affiliated hospitals. The survey content was developed in collaboration with the QITI to identify program director opinions regarding education in practice-based learning and improvement and systems-based practice, to investigate the status of quality improvement education in their respective programs, and to quantify the extent of resident participation in quality improvement.


RESULTS
There was a 57% response rate. Eighty-five percent of program directors (n = 57) reported that education in quality improvement is essential to future professional work in the field of surgery. Only 28% (n = 18) of programs reported that at least 50% of their residents track and analyze their patient outcomes, compare them with norms/benchmarks/published standards, and identify opportunities to make practice improvements.


CONCLUSIONS
Program directors recognize the importance of quality improvement efforts in surgical practice. Subpar participation in basic practice-based learning and improvement activities at the resident level reflects the need for support of these educational goals. The QITI will facilitate programmatic compliance with goals for quality improvement education.
Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Healthcare Economics, Wharton School, University of Pennsylvania, Philadelphia, PA. Electronic address: Rachel.Kelz@uphs.upenn.edu.
Rachel R
RR
Kelz
Morgan M
MM
Sellers
Caroline E
CE
Reinke
Rachel L
RL
Medbery
Jon
J
Morris
Clifford
C
Ko
D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004503:Education, Medical, Graduate / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014481:United States
ACGME; Accreditation Council for Graduate Medical Education; QI; QITI; Quality In-Training Initiative; quality improvement