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Outcomes of a Longitudinal Quality Improvement and Patient Safety Preclerkship Curriculum

Dumenco, Luba MD, MEHP; Monteiro, Kristina PhD; George, Paul MD, MHPE; Rougas, Steven MD, MS; Dollase, Richard EdD

doi: 10.1097/ACM.0000000000002898
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Purpose To evaluate whether quality improvement (QI) and patient safety (PS) training in preclerkship medical education resulted in students’ development and retention of knowledge, application-based and perceived skills, and attitudes throughout clerkships.

Method A longitudinal QI/PS curriculum with multimodal curricular components was implemented in the preclerkship curriculum between 2015 and 2017 at the Warren Alpert Medical School of Brown University, Rhode Island. Assessments were administered at baseline (T1), end of year 1 (T2), Clinical Skills Clerkship (T3), and end of clerkships (T4) in the intervention cohort (n = 97). In 2018, T4 data for this cohort were compared with a prior control cohort (n = 97) at T4.

Results Results of knowledge-based multiple-choice questions (MCQs) (t[134] = −1.57, P < .001) and application-based skills (t[132] = −8.91, P < .001) demonstrated significant improvement from T1 to T2 (intervention cohort). Assessments of perceived skills showed significant growth from T1 to T2 (t[137] = −23.38, P < .001). Performance on application-based skills significantly improved from T2 to T3 (t[123] = −4.11, P < .001). Compared with the control cohort, the intervention cohort had significantly higher scores on MCQs (t[187.88] = 3.98, P < .001), application-based skills (t[72.69] = 6.40, P < .001), perceived skills (t[106.99] = 5.24, P < .001), and attitudes (t[152] = 5.86, P < .001).

Conclusions Incorporation of preclerkship QI/PS training resulted in improvements in knowledge, application-based and perceived skills, and attitudes that were retained throughout clerkships.

L. Dumenco is assistant dean for medical education, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

K. Monteiro is director, Assessment and Evaluation, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

P. George is associate dean for medical education and director, Clinical Curriculum, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

S. Rougas is director, Doctoring Program, Office of Medical Education and Continuous Quality Improvement, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

R. Dollase is professor emeritus of medical education, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: This curriculum program evaluation did not require review by the Brown University institutional review board (supporting documentation available from authors upon request).

Previous presentations:

Monteiro K, George P, Dumenco L. Overview and longitudinal evaluation of a quality improvement & patient safety curriculum for medical students. Presented at: Association of American Medical Colleges Integrating Quality Conference; June 8, 2018; Arlington, Virginia.

Monteiro K, George P, Dollase R, Dumenco L. Introduction and evaluation of a quality improvement and patient safety curriculum for preclinical medical students. Presented at: The Generalists in Medical Education Conference; November 3, 2017; Boston, Massachusetts.

Monteiro K, George P, Dollase R, Dumenco L. An innovative quality improvement and patient safety curriculum for first year medical students. Presented at: Association of American Medical Colleges Integrating Quality Conference; June 7, 2017; Chicago, Illinois.

Correspondence should be addressed to Luba Dumenco, Office of Medical Education and Continuous Quality Improvement, Box GM 104, The Warren Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903; telephone: (401) 863-3992; email: Luba_dumenco@brown.edu.

Copyright © 2019 by the Association of American Medical Colleges