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Improving Graduate Medical Education, the Sequel

By Jeffrey Wetherhold | Wednesday, January 30, 2013
Innovation often leaves you with as many questions as answers.  We have discussed how our 90-day projects can lead to additional research questions in this space beforeIt can be counterintuitive to think about the outcome of an innovation project as another innovation project. Indeed, if another question was the only outcome it would be fair to wonder about the point of the whole enterprise. It pays not to ignore such questions though, and they can end up being some of the most valuable outcomes of a project.

Last month we shared a copy of our report on Embedding Quality Improvement in Medical EducationThe research, which was conducted in 2011, explored the infrastructural barriers to integrating quality improvement and safety principles in medical education with a focus on inpatient and acute settings. The research went on to influence a number of IHI's projects and partners. It also led to a great follow up question: What about primary care?

In the fall of 2012 our innovation team chartered a follow up project to tackle this question. Their goal was to build on the case studies and examples from the previous cycle to identify best practices in the ambulatory care setting and use these to refine our theory about how to successfully integrate quality improvement education. In particular, the team was interested in the pressures felt by academic ambulatory care practices around the quality and safety skills that are needed to prepare a new generation of practitioners for primary care practice amidst a rapidly changing landscape in the US. Some of the key questions that emerged were:
  1. How are trainees (and their programs) involved in teams to transform primary care?
  2. What is the role of the resident (trainee) on transformed primary care teams?
  3. How did the residency (education) structure change to facilitate practice transformation?

Now that this project has been completed we are pleased to be able to share our report on IHI.orgThe final recommendations include an emphasis on team-based practice and interprofessional learning, developing leadership skills, and professionalism within and across care settings. We hope it is helpful to anyone working in this area or interested in IHI's most recent learning. 

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