Creation of an Educational Quality Improvement Program for Radiation Oncology Residents

Publication date: Available online 29 November 2017
Source:Practical Radiation Oncology
Author(s): Catherine A Pembroke, Joanne Alfieri, Alain Biron, Carolyn Freeman, Tarek Hijal
PurposeQuality Improvement (QI) is a pillar of good clinical governance and is at the center of modern health care. The Royal College of Physicians and Surgeons of Canada mandated, in CanMeds 2015, that QI should be taught and the competencies assessed in all post-graduate residency programs.¹ The objective is to report on the feasibility and impact of teaching QI to radiation oncology residents at a single institution.Methods and MaterialsA QI team consisting of a clinical fellow and 3 staff physicians as well as an expert in QI methods was created within the Department of Radiation Oncology. QI teaching took place in a longitudinal manner with approximately 12 hours of direct faculty teaching. A mandatory curriculum divided into foundation, and intermediate and advanced competencies was devised. Phase 1 teaching, delivered during two academic half days, consisted of didactic lectures, practical workshops and self-directed online modules.² Phase 2 required intermediate year residents to complete a nine-month QI project. A QI day hosted by the Department invited QI experts to teach and enabled residents to present their work with merit prizes awarded. Our program evaluation used validated assessment tools (self-assessment, QI-knowledge based assessments (QI-KATs), and balanced score cards) before and after curriculum implementation and answers quantified using satisfaction indices (SI).^3,4ResultsSubjective and objective assessments demonstrated improvements in resident's QI knowledge acquisition following curriculum implementation. Those who had completed a project (n=4) had greater confidence with QI methodology compared to those who had completed phase 1 (n=2) alone (mean SI 53% pre-curriculum to 66.5% and 90%). The majority lacked previous QI teaching and knowledge but learner attitudes improved (SI 50 to 70%) and 91% of colleagues were enthusiastic about the program being implemented.ConclusionWe have demonstrated that implementation of a QI curriculum for radiation oncology residents is feasible and that early results suggesting improvements of attitude and knowledge are positive. We anticipate that the QI skills gained will enable the residents to elevate the quality of their practice throughout their subsequent careers.SummaryQuality Improvement (QI) is a pillar of good clinical governance and is at the center of modern health care. We describe how a two-phase longitudinal QI curriculum for radiation oncology residents was implemented and formally evaluated. Improvements in subjective and objective QI knowledge and attitudes were demonstrated amongst residents and attending physicians. We anticipate that equipping residents with QI professional skills will help elevate quality standards throughout their subsequent careers.



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