Abstract
BackgroundQuality improvement (QI) is an essential component of modern clinical practice. Front-line professionals offer valuable perspectives on areas for improvement and are motivated to deliver change. In the UK, all junior doctors are expected to participate in QI in order to advance to the next stage of their training. However, UK undergraduates receive no standardized training in QI methods. This is perpetuated within medical schools by a lack of teaching capacity and competing priorities, and may lead to tokenistic engagement with future QI projects.MethodsWe describe a near-peer teaching programme designed to introduce students to QI methods. This pilot study was conceived and delivered in full by junior doctors and used existing resources to ensure high quality teaching content. 111 fifth-year medical students from the University of Cambridge were taught in interactive, participative workshops that encourage them to develop their own QI change ideas and projects. Core topics included the model for improvement, driver diagrams, stakeholder engagement, measurement for improvement and analysing and presenting data. Students completed surveys before and immediately after this intervention to assess their understanding of and confidence in utilizing QI methods. Questionnaires were also completed by junior doctor tutors.ResultsAnalysis of questionnaires completed before and immediately after the intervention revealed statistically significant improvements in students’ self-reported understanding of QI (p < 0.05) and confidence in applying techniques to their own work (p < 0.05). Students expressed a preference for QI teaching delivered by junior doctors, citing a relaxed learning environment and greater relevance to their stage of training. Tutors reported increased confidence in using QI techniques and a greater willingness to engage with QI in future.ConclusionsIn this single-centre study, near-peer teaching produced significant improvements in students’ self-reported understanding of QI and confidence in applying QI methods. Near-peer teaching may constitute a sustainable means of teaching essential QI skills at undergraduate level. Future work must evaluate objective measures of student engagement with and competence in conducting QI.
Highlights
Quality improvement (QI) is an essential component of modern clinical practice
QI is increasingly viewed as a crucial part of medical education, equipping junior
Student understanding of QI and confidence in using QI techniques Confidence in understanding of QI techniques increased following teaching (p < 0.05), with mean Likert scores for the question ‘How confident are you in your understanding of what QI is?’ rising from 2.8 to 4.4 (Fig. 2)
Summary
Quality improvement (QI) is an essential component of modern clinical practice. Front-line professionals offer valuable perspectives on areas for improvement and are motivated to deliver change. UK undergraduates receive no standardized training in QI methods This is perpetuated within medical schools by a lack of teaching capacity and competing priorities, and may lead to tokenistic engagement with future QI projects. QI is increasingly viewed as a crucial part of medical education, equipping junior doctors with the skills to enhance patient experience and outcomes, improve population health, and reduce per capita cost of healthcare [2]. Many junior doctors fail to complete mandatory QI projects during their training [5], citing poor knowledge of QI methods [6]. This is unsurprising given the lack of standardized and universal undergraduate QI teaching at UK medical schools [7]
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