A General Surgery Resident Active Learning Curriculum for Quality Education

Abstract

INTRODUCTION: Formal resident education regarding quality improvement (QI) and process improvement (PI) is limited in general surgery, nationwide. Development and delivery of an active learning QI curriculum increased general surgery resident education and participation in quality initiatives. METHODS: A total of 60 general surgery residents participated in monthly active learning lecture and workshop sessions. Sessions progressed through the selection and completion of a PI project, including scope, key stakeholder buy-in, data collection, process mapping, implementation, standardization, and auditing. A focused framework based on an adapted Lean methodology for healthcare QI was used. RESULTS: Before curriculum development, no active QI learning was integrated into the educational curriculum and 1 of 60 residents were engaged in scholarly activity related to PI. Project ideas derived from resident workflow hardships contributing to burnout and resident dissatisfaction. Next, residents were divided into 4 implementation teams, each tasked with completing components of the project, including preliminary data, stakeholder discussions, process mapping, and implementation. Monthly group sessions discussed completed tasks. Engagement in process improvement education yielded all residents participating in at least 1 QI project, and 13% of residents engaged in a second QI initiative. Overall, residents initiated 6 QI projects across 2 institutions during the process of the QI curriculum (Table). Table. - Curriculum Sessions and Objectives Session number Topic Workshop activity 1 Identify Opportunity Focus groups Root cause analysis 2 Process Selection Project scope Stakeholder engagement Preliminary data 3 Process Mapping Process map current and ideal workflows 4 Intervention Ideate interventions Implementation plan 5 Barriers Overcoming barriers 6 Data Collection Metrics Data analysis 7 Standardization and Auditing Internal standardization Audit sheet creation Identify auditing frequency 8 Continuous Improvement Identify opportunities for further improvement CONCLUSION: An active, ongoing learning curriculum model for QI education is an effective methodology for designing and engaging surgery residents in QI initiatives. Additionally, this model provides residents with the necessary tools to identify and change areas in need of improvement in their daily work.