Continuous Quality Improvement for Psychiatry Residency Didactic Curricula.
Continuous Quality Improvement for Psychiatry Residency Didactic Curricula.
复制标题
精神病学住院医师教学课程的持续质量改进。
DOI：
10.1007/s40596-018-0908-4
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Beach,ScottR
中科院分区：
文献类型：
--
作者：
Benson,NicoleM;Vestal,HeatherS;Puckett,JudithA;Taylor,JohnB;Hogan,Charlotte;Smith,FeliciaA;Beach,ScottR
精神病学领域正在迅速发展，住院医师教学课程也必须发展，以保持最新和相关的学习者。然而，确保教育内容的持续修订可能是住院医师计划的重大挑战。课程修订是一个复杂的过程，既需要教师对计划、实施和监督的投入，也需要学习者自己的反馈。很难获得关于每个教学的一致和有意义的反馈，也很难解释这些反馈来通知课程的变化。收集和解释反馈的行政资源是稀缺的，居民的评论在刚开始的后教学时期可能过于反动，教师可能抵制建议的改变。在缺乏具体的建设性反馈的情况下，教学教师可能会年复一年地讲授相同的课程。虽然持续课程修订的重要性已经得到强调[2,3]，但据我们所知，文献中没有描述任何模型来指导住院医师项目系统地审查和修改精神病学教学课程，以确保高质量的教学和最新的内容。在麻省总医院(MGH)/麦克莱恩医院成人精神病学住院医师，一个拥有两个主要教学校区的大型项目，整个教学课程（定义为任何正式的预定教学，讨论式课程或体验式学习研讨会）在2012年进行了系统修订。随着新课程的推出，项目领导制定了一个持续审查和改进课程教学内容和教学方法的过程。本教育案例报告描述了一种新颖的住院医师教学课程的持续质量改进（CQI）过程，该过程使住院医师成为该过程的关键参与者。CQI过程是改进质量的系统方法，通常使用计划-执行-研究-行动循环，通过识别质量改进机会（计划）、实施变更（行动）、收集反馈（研究）和监控过程的持续修订（行动）。CQI已成功地应用于医疗保健服务的多个领域。本文中描述的住院医师教学课程的CQI过程包括三个组成部分：(1)征求住院医师的反馈，(2)创建住院医师驱动的课程小组委员会，以审查和总结反馈并建议课程更改，以及(3)利用课程委员会推荐课程更改并向教师提供反馈。副项目主任（APD）在项目主任的支持和指导下，主要负责监督和实施这一过程。
The field of psychiatry is rapidly evolving, and residency didactic curricula must also evolve in order to remain up-to-date and relevant to the learner. However, ensuring continuous revision of educational content can be a significant challenge for residency programs. Curriculum revision is a complex process that requires input from faculty for planning, implementation, and monitoring, as well as feedback from learners themselves [1]. It can be difficult to obtain consistent and meaningful feedback about each didactic and to interpret the feedback to inform curriculum changes. Administrative resources for gathering and interpreting feedback are scarce, resident comments may be overly reactionary in the immediate post-didactic period, and faculty may be resistant to suggested changes. In the absence of specific constructive feedback, didactic instructors may deliver the same session year after year. Though the importance of ongoing curricular revision has been emphasized [2, 3], to our knowledge, there are no models described in the literature to guide residency programs in systematically reviewing and revising a psychiatry didactic curriculum on an ongoing basis to ensure high-quality teaching and up-to-date content. At the Massachusetts General Hospital (MGH)/McLean Hospital Adult Psychiatry Residency, a large program with two primary teaching campuses, the entire didactic curriculum (defined as any formal scheduled teaching, discussion-based lessons, or experiential learning-based seminars) was systematically revised in 2012 [4]. Following the launch of the new curriculum, program leadership developed a process for ongoing review and improvement of the didactic content and teaching methodologies in the curriculum. This educational case report provides a description of a novel continuous quality improvement (CQI) process for residency didactic curricula that engages residents as key participants in the process. CQI processes are systematic approaches to improving quality, often using the plan-do-study-act cycle, by identifying quality improvement opportunities (plan), implementing change (do), collecting feedback (study), and monitoring ongoing revision of the process (act). CQI has been used successfully in multiple areas of healthcare delivery [5].The CQI process for residency didactic curricula described in this manuscript consists of three components:(1) soliciting feedback from residents,(2) creating resident-driven curriculum subcommittees to review and summarize feedback and recommend curricular changes, and (3) utilizing a curriculum committee to recommend curricular changes and deliver feedback to faculty. The Associate Program Director (APD), with support and guidance from the Program Director, is primarily responsible for overseeing and implementing this process.