title: Building bridges: engaging medical residents in quality improvement and medical leadership.
abstract: OBJECTIVE
  To develop an educational intervention that targets residents' beliefs and attitudes to quality Improvement (QI) and leadership in order to demonstrate proactive behaviour.
  
  
  METHODS
  Theory-driven, mixed methods study including document analysis, interviews, observations and open-ended questionnaires.
  
  
  METHODS
  Six Dutch teaching hospitals.
  
  
  METHODS
  Using expertise from medicine, psychology, organizational and educational sciences we developed a situated learning programme named Ponder and IMProve (PIMP). The acronym PIMP reflects the original upbeat name in Dutch, Verwonder & Verbeter. It has a modern, positive meaning that relates to improving your current circumstances. In quarterly 1-h sessions residents are challenged to identify daily workplace frustrations and translate them into small-scale QI activities.
  
  
  METHODS
  Organizational awareness, beliefs and attitudes to QI and organizational responsibilities, resident behaviour, barriers and facilitators to successful learning and the programme's potential impact on the organization.
  
  
  RESULTS
  Overall, 19 PIMP meetings were held over a period of 3 years. Residents defined 119 PIMP goals, resolved 37 projects and are currently working on another 39 projects. Interviews show that PIMP sessions make residents more aware of the organizational aspects of their daily work. Moreover, residents feel empowered to take up the role of change agent. Facilitators for success include a positive cost-benefit trade-off, a valuable group process and a safe learning environment.
  
  
  CONCLUSIONS
  This article demonstrates the added value of multidisciplinary theory-driven research for the design, development and evaluation of educational programmes. Residents can be encouraged to develop organizational awareness and reshape their daily frustrations in QI work.
authors: Staff Department Executive Board, University Medical Center Utrecht, Utrecht, the Netherlands.|Public Management, Utrecht School of Governance, Utrecht University, Utrecht, the Netherlands.
authors: Judith J
authors: JJ
authors: Voogt
authors: Quality & Patient Safety Department, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Elizabeth L J
authors: ELJ
authors: van Rensen
authors: Educational Sciences, Utrecht University, Utrecht, the Netherlands.
authors: Marieke F
authors: MF
authors: van der Schaaf
authors: Public Management, Utrecht School of Governance, Utrecht University, Utrecht, the Netherlands.
authors: Mirko
authors: M
authors: Noordegraaf
authors: President of the Executive Board, University Medical Center Utrecht, Utrecht, the Netherlands.
authors: Margriet Me
authors: MM
authors: Schneider
mesh_terms: D000328:Adult; D004503:Education, Medical, Graduate; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D007857:Leadership; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D016730:Program Development; D058996:Quality Improvement / Q000458:organization & administration*
keywords: leadership; postgraduate education; quality improvement