To Improve Postgraduate Training: Medical Residents′ Input in Residency Quality Improvement

Abstract

The "Open Space Technology" (OST) is an innovative group process introduced by Harrison Owen in 1997. There is some evidence for its effectiveness in education quality improvement. However, its application in higher education has not been reported. Our objective was to apply a modified OST as a quality improvement tool in a postgraduate training quality improvement program at a university hospital in Argentina. OST is a method in which a program's participants propose and discuss topics of their interest with an aim that had been defined for them by coordinators. After proposing and writing down themes important to improving the quality of their postgraduate training, residents were divided into small groups to discuss the suggested topics for 90 minutes. They then reconvened in the large group and presented the conclusions of their small group discussions. Thirty-six percent of residents (75/208) participated in one of the two OST sessions. Topics suggested by participants were similar in both sessions: (1) work hours, (2) work conditions, (3) residency curriculum, (4) residents' duties, (5) salaries, (6) professional burnout, (7) patient care load, and (8) interdisciplinary activities. In only four hours, residents were able to share their concerns and proposals for improving the quality of their residencies with their faculty. Most of the topics they suggested were subsequently included in the program's quality improvement agenda.