Why It Matters
Quality improvement is best learned through practice. That’s why the IHI Open School Chapter at Duke University developed their own six-month practicum program based on the IHI Open School curriculum.
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Learning by Doing: Duke Students Lead Interprofessional Quality Improvement Practicum

By IHI Open School | Tuesday, November 10, 2015

Duke University's Quality and Innovation Scholars Program (QISP) matches students with physicians and leaders in the Duke Health System to carry out health care improvement projects. So far, the program has reached almost 70 students. In the following interview, Chapter leaders Kathryn Hutchins and Maria Andrews explain how the Chapter got the program off the ground and how other Chapters can create their own practicum.

OS: How did the Quality and Innovation Scholars Program (QISP) get started?

KH and MA: In 2011, the IHI Open School approached Duke Open School leaders to be a pilot school for what was at the time a brand new practicum module and project framework. Under some great Chapter leaders and mentors — Dr. Dev Sangvai and Dr. Jonathan Bae — the practicum was adapted to Duke, and blossomed in the 2013–2014 academic year. That work built on the model that the Open School created and has become the current Duke format over the past few years.

OS: Why did you design it as a six-month program?

KH and MA: We chose this time frame with graduate student schedules in mind. We wanted something that would be lengthy enough to complete a meaningful project, but not so long that it would interfere with graduate program requirements or be difficult for busy students to fit into their schedules. The time frame from October to April seems to work well for our students and mentors.

So far, we’ve had scholars from many Duke graduate programs, including the School of Medicine, the Fuqua School of Business, the Sanford School of Public Policy, the School of Nursing, the Pratt School of Engineering, and the Duke Global Health Institute.

OS: How have the Open School modules helped students complete the practicum?

KH and MA: The Open School modules provide a foundation for what students learn in the hands-on phase, and ensures that students are prepared to learn from their projects and from their mentors. Students in the past have described the modules as “a good balance between challenging and simple,” with useful information that helped them develop a better framework for their practicum work.

OS: What do students learn through the practicum that they wouldn’t if they only took the online courses?

KH and MA: While it’s valuable to learn about these topics in the modules, it’s a completely different experience to participate in an interdisciplinary QI or health care innovation project. By joining a mentor and a team, our scholars are able to form meaningful relationships with other passionate leaders in our rapidly changing health care system. It’s also great that these projects provide the chance to present at conferences and publish pieces on their work, which can be a wonderful learning opportunity.

Duke quality improvement practicum

This graphic illustrates how Duke Chapter leaders intended experiential learning to build on didactic skills learned through the Open School’s online courses.

OS: How do you find clinicians who wanted to work on QI projects with students?

KH and MA: At Duke University Hospital, health care providers and even administrators often work in proximity to students. Many of our mentors are teaching physicians who are passionate about student and resident education as well as about quality improvement. These providers, as well as our administrative mentors, also understand the importance of interdisciplinary work. For these reasons, they are excited to include our scholars in their clinical environment in order to facilitate QI projects. 

OS: How do you choose practicum projects and assign students to teams?

KH and MA: Through the guidance of our faculty advisor, we reach out to faculty at Duke, describing the goals and components of QISP. We then generate a list of projects that are appropriate for the program and ensure that the mentors understand their teaching and facilitating role. On the student application, we ask for specific interests (pediatrics, emergency medicine, and outpatient primary care, for example) and have students list any background or skills (such as statistics, finance, or software engineering). We do our best to assign students to projects that match their interests and skills, and attempt to make teams of two to three students with complementary abilities. 

OS: What role have faculty and students played in developing this program?

KH and MA: QISP is primarily student-led. Students drive the recruitment of scholars and mentors, and make decisions that determine the structure and components of the program. In the beginning stages of QISP around 2011, our faculty advisory council was central to the logistical formulation and promotion to faculty and students. But IHI student leaders really developed the idea. Over the past two years, our current faculty advisor, Dr. Jonathan Bae, has been an enormous resource in developing and growing QISP. As an internal medicine physician at Duke and a major player in the QI and patient safety scene, he was able to direct us to many other potential mentors who share his passion for quality improvement and mentorship.

OS: Why do you think interdisciplinary experience is so important to training health care professionals?

KH and MA: Health care is inarguably a team sport. In order to provide the best possible patient care, it’s imperative that health professionals of different disciplines work together and contribute to the same goal. Facilitating interdisciplinary work and building relationships between these students of different disciplines at such an early stage will strengthen interdisciplinary work later in their careers.

OS: What advice would you give another Chapter that was interested in developing a similar learning experience for students at their school?

KH and MA: Listening to both the mentors and students about the ideal qualities of the program has been a meaningful starting point. It has been absolutely critical to assess the program, evaluate its progress — as well as its hiccups, setbacks, and speedbumps — and get feedback along the way. Survey interested parties, hold info sessions, and save copies of everything! Find leaders with a passion for bringing students into the world of QI, and develop an experience that fits your system.

 

Learn more about the IHI Open School Quality Improvement Practicum.

Read about one student’s Practicum project to improve depression screening in diabetic patients.

New to the IHI Open School? Learn more or take a free sample course, QI 102: The Model for Improvement: Your Engine for Change.

 

The Duke IHI Open School Chapter offers special thanks to faculty mentors Dr. Jonathan Bae, MD; Dr. Dev Sangvai, MD; Paula Greeno, MBA; and Dr. Janet Prvu Bettfer, ScD/FAHA; and student leaders Arthika Chandramohan, Ashley Humienny, Marisa Dowling, Lauren Groskaufmanis, Tony Chen, and Katie Falloon for their help in launching and developing the QISP program.

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