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A Curriculum in Continuous Quality Improvement for Surgery Residents

David F. Canal, MD; Laura Torbeck, PhD; Alexander M. Djuricich, MD

Arch Surg. 2007;142:479-483.

Hypothesis  Surgery residents can learn continuous quality improvement (CQI) principles within a structured curriculum and propose quality improvement projects.

Design  Curriculum within a surgical residency program.

Setting  A university surgical residency program with multiple hospital training sites.

Participants  Fifteen surgical residents during the dedicated research year.

Intervention  A curriculum in CQI that focuses on devising a quality improvement project.

Main Outcome Measures  Resident self-reported attitudes about quality improvement and implementation of resident-initiated quality improvement projects.

Results  Resident survey data demonstrated an improvement in knowledge, self-efficacy, and experiences within CQI. Fifteen individual residents, within smaller teams, created 4 quality improvement projects worthy of implementation.

Conclusions  A structured CQI curriculum can be successfully integrated into a general surgery residency program. Residents can learn the skill of constructing CQI project ideas within the framework of the plan-do-study-act cycle. Residents are eager to make improvements in their local system of residency. By giving them the tools to critically investigate systems improvement and a much needed ear to hear their concerns and suggestions for improvement, we found ways to potentially enhance patient care and developed ideas to improve the education of future surgeons. In doing so, we provided the residents with "buy-in" into their residency program, while addressing the competency of practice-based learning and improvement required by the Accreditation Council for Graduate Medical Education for resident education.

Author Affiliations: Departments of Surgery (Drs Canal and Torbeck), Medicine (Dr Djuricich), and Pediatrics (Dr Djuricich), Indiana University School of Medicine, Indianapolis.

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