Relevant themes from realist review
| What works | Accurately account for the time it takes to deliver QI education in the clinical setting due to competing demands, existing work load of trainees, and work-hour rules |
| Identifying educational and clinically relevant project topics is challenging | |
| Consider having trainees choose their own project | |
| Choose topics of clinical importance | |
| Use near misses as a way to identify system errors | |
| For whom | Medical students can, and should be expected, to contribute to quality of care in the clinical setting |
| Residents are front-line providers and have deep insights into the clinical processes and the knowledge for improvement within the system | |
| Under what circumstances | Successful QI teaching in the clinical setting requires support from both educational and care delivery leaders and the work of the trainees |
| Data are critical. The availability of data, especially through health information technologies, has a direct positive impact on learner satisfaction and engagement | |
| Opportunities for interprofessional engagement and education can be found in teaching about QI within the clinical setting | |
| Programs can be successful by either engaging all faculty around QI or by having dedicated QI faculty for teaching QI within the clinical setting | |
| To achieve what outcomes | There is lack of clarity around whether educational and clinical outcomes are of equal or relative hierarchical importance |
| Sustainability is important for the clinical setting and the trainee. Sustainable projects can impact the culture of the clinical setting, but unsustainable projects may leave the trainee and other participants disheartened about improvement work |
QI, quality improvement.