673 - Sustainability of an Innovative Resident led Quality Improvement Curriculum

Poster Number: 673
Publication Number: 673.151

Sofia E. Chang Escobar, Albert Einstein Medical Center Philadelphia, Philadelphia, PA, United States; Mayssa Abuali, Einstein Medical Center Philadelphia/Jefferson Network, Philadelphia, PA, United States; Afaf Ahmed, Einstein medical center philadelphia/Jefferson network, Philadelphia, PA, United States; Reymundo C. Bisarini, Einstein Medical Center - Philadelphia, Philadelphia, PA, United States; Khang Nguyen, Albert Einstein Medical Center, Philadelphia, PA, United States; Rabail Jarwar, Einstein Medical Center Philadelphia/Jefferson Network, Philadelphia, PA, United States; Shaquavia R. Hardy, Einstein Medical Center Philadelphia/Jefferson Network, Philadelphia, PA, United States; Ali Abdelhafiz, Einstein Medical Center Philadelphia, Philadelphia, PA, United States

Background: Quality improvement (QI) learning is a residency training requirement. While previous work has highlighted resident run longitudinal QI projects, less is known on outcomes of resident led QI educational curriculums

Objective: To evaluate the impact and sustainability of a resident-led QI educational curriculum on QI competencies through learner assessment over two academic cycles.

Design/Methods: Our residency program consists of 30 Pediatric residents (10/year). In January 2020, a needs assessment showed gaps in QI skills among our residents. Starting in April 2021, three second year resident self-nominated QI champions (cohort 1) were trained to teach basic QI principles and skills utilizing online modules, flipped classrooms and skill building workshops. From July-November 2021 (cycle 1), we conducted the pilot curriculum. In May 2022, cohort 1 recruited and trained four incoming second year residents (cohort 2) to continue peer teaching. In July-November 2022 (cycle 2), both cohorts conducted a total of 6 workshops and 7 lectures. Expert faculty led 2 small group sessions. To assess impact on learner competency, we conducted a post curriculum assessment at the end of each cycle using resident surveys of comfort level with QI skills (1-5, 5 being the highest), and the QIKAT-R validated tool (3 points each for AIM, Measure, Change) used to assess QI skills on three simulated clinical scenarios.

Results: 20 residents participated in the pilot curriculum during cycle 1 (2021), and 19 residents participated in cycle 2 (2022). Not all participants completed QIKAT scenarios. On post curriculum self-assessments, comfort constructing a SMART(IE) AIM was 65 % in 2021, increased from 18 % at baseline, and 63% in 2022 at highest levels (4-5). Ability to develop measures was 30 % in 2021 up from 18 % at baseline, and 47% % in 2022 (figure 1). Ability to construct a run chart increased from 12 % to 30 % to 32 %.  QIKAT scores were comparable among cycle 1 and 2 (figure 2). Residents continue to show interest in learning QI.

Conclusion(s): Our curriculum highlights the potential of an innovative train the trainer curriculum model, where residents are trained to teach their peers foundational QI principles and skills. Sustainability was demonstrated as we maintained improvements in learner comfort level with QI skills over two years. Next steps include training new QI champions to sustain the curriculum and improving QIKAT scores by allowing residents to lead more PDSA cycles in real time.