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Measuring outcomes in quality improvement education: success is in the eye of the beholder
  1. Jennifer S Myers1,2,
  2. Brian M Wong3,4,5
  1. 1 Center for Healthcare Improvement and Patient Safety, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  2. 2 Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  3. 3 Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  4. 4 Centre for Quality Improvement and Patient Safety, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  5. 5 Division of General Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
  1. Correspondence to Dr Brian M Wong, 2075 Bayview Avenue, Room H466, Toronto, Ontario, Canada, M4N 3M5; BrianM.Wong{at}

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Over the past decade, quality improvement (QI) has gone from a secret skill expected only among trained staff in the quality office to a core competency for all health professionals.1–3 This expectation has generated new curricula which have introduced QI to a new generation of learners, but has also created some challenges for health professions educators.4–7 Identifying knowledgeable teachers, defining core content and securing time in the curriculum represent recurring issues, while emerging discussions now centre on how best to evaluate educational efforts in QI. It is here that we find ourselves at an impasse.

In this issue of BMJ Quality and Safety, O’Leary and colleagues present their 5-year experience delivering an institutionally sponsored, team-based QI training programme which included attending physicians, residents and fellows and frontline interprofessional team members. They report on its impact on both learner outcomes and project outcomes.8 Their programme demonstrated improvements in participant knowledge, with 172 individuals comprising 32 teams reporting that they had applied their new knowledge and skills to improve clinical quality (87%) and implement QI interventions (62%) at 6 months. At 18 months, nearly half reported leading other QI projects (48%) and many had provided QI mentorship to others (41%). In addition to measuring these learner-focused outcomes, the authors summarise QI project outcomes at programme completion, 6 and 18 months. At one or more of these time points, 20 out of 32 projects (63%) had positive results, defined as showing improvement in one or more project measures without any measure declining in performance. This comprehensive programme evaluation, which includes both learner and project outcomes, provides a unique opportunity to reflect on the goals of QI education for the field of health professions education.

Before reflecting on the goals of QI education specifically, it is important to review the yardstick by which best …

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