In March, Eastern Virginia Medical School (EVMS) became the first medical school in the United States to require its students to earn the IHI Open School Basic Certificate in Quality & Safety before graduation. Starting this summer, EVMS students will be required to complete all 16 self-paced, interactive, online modules in quality improvement (QI), patient safety, leadership, patient- and family-centered care, and managing health care operations that comprise the Certificate between their first and second years.
“Introducing these topics to students early will be much more effective than doing it later in their careers,” said Ronald Flenner, the associate dean of education at EVMS. “We are trying to reintroduce the importance of patient safety and professionalism.”
And EVMS isn’t alone.
Two other health professions schools—University at Buffalo School of Nursing, and Texas A&M College of Medicine—will start requiring the Certificate within the next calendar year. Buffalo will start this summer, and Texas A&M plans to start during the 2012-2013 academic year. A third school, Loma Linda University in California, has been requiring fourth-year medical students to complete 14 of the IHI Open School courses since July of 2011.That requirement will continue this summer.
“When I found out about the IHI Open School, I thought, ‘This is perfect,’” said Dr. Ariane Marie-Mitchell, a member of the preventive medicine department and facilitator of the senior rotation in Preventive Medicine & Public Health at Loma Linda. “Why should I reinvent the wheel [to create a curriculum] when IHI is a national leader in the area and has already made the learning interactive and flexible?”
Marie-Mitchell gives her medical students two full days (16 hours) to complete the patient safety and quality improvement courses during the month-long rotation. The dean’s office, she says, has been very supportive of the innovative learning experience that also includes time to complete a health care improvement project.
“Students don’t necessarily see this as part of their role in being a good doctor yet,” she says. “But that’s what I try to communicate. No matter what their role is, QI methods give you a way to accomplish things. To me, it is part of good patient care.”
It’s also useful in landing the right residency. Marie-Mitchell says that her students tell her that completion of the IHI Open School courses made a big impression during residency interviews.
“One student told me that that’s all they wanted to talk to him about,” she said.
Susan Grinslade, PhD, RN, APRN, BC, and Sharon Hewner, PhD, RN, the professors who inserted the IHI Open School courses into the curriculum at the University at Buffalo School of Nursing, feel the same way.
“Health care is becoming so complex and nurses are taking care of more complex patients. They are functioning within systems that are not always the safest places,” said Hewner. “The [IHI Open School] courses help us reinforce the lesson we’re teaching. They help provide a mirror of what is going on out there in health care.”
Faculty members at the school, including Grinslade and Hewner, have used many of the courses within the curriculum for a couple years, but thanks to positive feedback, will to require all 16 courses starting this summer. Students in all three nursing programs—the traditional one for four-year students, an accelerated one for those who have a bachelor’s degree in other disciplines, and a new online program for those that have an associate’s degree in nursing—will be required to earn the IHI Open School Basic Certificate in Quality & Safety. In addition, the online modules will be inserted into a number of courses, including “Promoting Quality Health Outcomes & Culture of Safety”
“We were really looking for new and creative ways to include the concepts to the curriculum,” Grinslade said.
Already, faculty members at the school are seeing positive changes in the students because of the increased focus on quality improvement and patient safety.
“You can see it in how they are talking about quality outcomes in their ‘Evidence-Based Practice and Nursing Research’ course,” Grinslade says. “And the seniors, in one course, allocate resources and make presentations to a nurse manager to learn about the cost of poor quality. The presentations have just been outstanding.”
Texas A&M will follow a somewhat different model, requiring students to complete certain IHI Open School modules in each year of study as part of a four-year, systems-based practice course. After each year, the class will come together for a team-based learning conference that includes a discussion of cases. Dr. Paul Ogden, the vice dean of academic affairs, said the school is still working out the final details.
However it’s done—as part of a rotation, woven into a curriculum, or in the summer months between years—more and more students are getting early knowledge of skills they need to understand systems and make improvements when they become professionals.
“To me, the idea that patient safety and quality improvement are part of patient care—and part of what we teach—is fundamental,” Marie-Mitchell said. “These courses are a stepping stone.”
Editor’s Note: To read more about how Eastern Virginia Medical School is using the IHI Open School Basic Certificate in Quality & Safety, read this article.