Medical School in Virginia First to Require IHI Open School Certificate for Graduation

March 2012

Medical student Chris Hoedt had a few goals when he started the IHI Open School Chapter at Eastern Virginia Medical School (EVMS) in 2008. He wanted to create a vibrant community of students and faculty. He wanted to create a strong partnership with local health care organizations. And, someday, he wanted the IHI Open School Basic Certificate in Quality & Safety—awarded for completing the Open School’s online courses in quality improvement and patient safety—to be a requirement for graduation from EVMS.

That day arrived last week, as EVMS became the first medical school in the United States to formally require students to complete the IHI Open School Basic Certificate in Quality & Safety before they become residents. The change will take effect this summer.
“We all become health professionals in order to improve the quality of people's lives,” Hoedt says. “The IHI and these courses help us learn how we can do that task to the best of our abilities.”
Dozens of medical, nursing, and pharmacy schools around the globe use the IHI Open School’s 16 online courses—which also focus on leadership, patient- and family-centered care, and managing health care operations—within their curriculums. Many use one or two courses, while others use almost all of them. The College of Medicine at Howard University and Northeast Ohio Medical University, for example, use the entire catalog.
But EVMS is the first to actually require completion of all 16 Open School online courses for graduation.
“We’re really excited about all of this,” Hoedt says. “At EVMS, we learn practical medical education, but the courses will help us learning the interprofessional, on-the-job applications. The IHI [Open School] lessons really break those skills down for you.”
Hoedt said that many students in their Chapter contributed to this change. He also lists a number of key administrators at the school and at nearby Sentara Health who helped lead the charge to make the IHI Open School Certificate a requirement for graduation. Dr. Richard Bikowski, the chief quality officer at EVMS, Dr. Gary Yates, the chief medical officer at Sentara, and Dr. David Levin, the former vice president of medical informatics at Sentara, all made significant contributions in the past three years.
But Hoedt puts the brightest spotlight on Dr. Ronald Flenner, the associate dean of education at EVMS.
“He really explained the strength of the IHI to the medical education committee and encouraged others to believe in the change,” Hoedt says.
Flenner, an internist who specializes in infectious diseases, believes the courses will add a crucial component to the education of the students at EVMS.
“There are so many opportunities for improving patient safety and quality improvement in health care,” Flenner says. “Introducing these topics to students early will be much more effective than doing it later in their careers. They’ll be much more likely to retain the information.”
Students at EVMS will be required to complete all the courses in the summer after their first year of medical school. Then they’ll take the seven patient safety courses again as a refresher after their second year. Flenner hopes this will help bring back some of the professionalism and responsibility that seems to have disappeared from health care. “With this requirement, hopefully this will be on the forefront of students’ minds,” he says.
Hoedt, who has taken all the courses, agrees. And now he’s interested in setting up a network of similar schools—medical or otherwise—that make the IHI Open School Basic Certificate in Quality & Safety a requirement.
How can other students help make it happen on their campuses? Hoedt says there are five critical steps:
  1. Set up an IHI Open School Chapter on campus. “It was really important to get this club set up and established,” says Hoedt. More and more students attended meetings, as the interest about patient safety and quality improvement around campus grew.
  2. Create some buzz about the topics. EVMS created a Vice President of Education position within its Chapter to work with administration and make it a priority to include more teaching about quality improvement and patient safety in the curriculum. “And slowly,” Hoedt says, “we found some professors willing to include some of the courses in their classrooms.”
  3. Connect with your local health care organization. The EVMS Chapter requested to co-sponsor quality and patient safety events with local hospitals to increase their presence and allow more student interaction with practicing professionals. They forged a strong connection with Sentara Health, asking health care professionals to come and speak to them on campus. They also work with Sentara on quality improvement projects. “Building that relationship really helped build the reputation of our group,” Hoedt says.
  4. Do something bold. The Chapter spoke to the associate dean of students, Dr. Michael Solhaug, who agreed to add a paragraph to their Dean's Letter of Recommendation for residency applications if they completed the basic certificate. Next, they requested a seat on the Medical Education Committee, a group that meets monthly to discuss any potential changes to the curriculum. The Chapter was denied, but “it showed we were serious,” says Hoedt. “And it allowed us to have a better relationship with the committee.”
  5. Get some well-respected health professionals on your side. Hoedt pinpoints this as the most important step. Getting support and buy-in from well-respected physicians at EVMS and Sentara proved invaluable in changing the curriculum. “Slowly, we got some heavy hitters on board and it helped us let the school know we really wanted this to be a requirement,” Hoedt says. “It’s really about all networking.”
Editor’s Note: For more information about EVMS and requiring the IHI Open School Basic Certificate in Quality & Safety, email Chris Hoedt. 
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