1st December 2017, Volume 130 Number 1466

Michelle R Wise, Bridget Kool, Lynn Sadler, Roshini Peiris-John, Gillian Robb, Susan Wells

Clinician engagement in ongoing health service quality improvement (QI) is an important component of improving clinical outcomes. Integrating QI in undergraduate and postgraduate medical education to equip clinicians with the…

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Summary

Final year medical students at University of Auckland perform a clinical audit project within the constraints and context of a busy women’s health service. Students work with a clinical supervisor to identify an area for potential improvement, set a standard of care, measure current practice, investigate reasons for not achieving the standard and make real-world suggestions to close the gap between research and observed practice. Since 2004, over 1,250 student projects have been completed, many of which have resulted in actual improvements to clinical care. Such experiential learning during medical school is important in preparing future doctors to incorporate quality improvement knowledge and skills into their daily practice.

Abstract

Aim

To describe how we incorporate experiential quality improvement (QI) learning at the University of Auckland by integrating a clinical audit project into the Year 6 obstetrics and gynaecology clinical attachment.

Method

Students gain insight into the relevance of QI while engaged in day-to-day clinical work. Students work with a clinical supervisor to identify an area for potential improvement, set a standard of care, measure current practice, investigate reasons for deviation from the standard and make real-world suggestions to close the gap between best evidence and observed practice.

Results

Since 2004, over 1,250 projects have been completed, and two journal articles published. Many of the student projects result in actual improvements to clinical processes of care, and lead to strengthening of academic and service provider learning networks and partnerships.

Conclusion

Performing a hands-on project within the constraints and context of a busy women’s health service is a feasible and effective method of teaching QI. Medical schools have an integral role to play in ensuring future healthcare professionals are equipped with QI knowledge, skills and attitudes. Experiential QI learning enhances clinical teaching and training, and is important in preparing future clinicians to incorporate QI into their daily practice.

Author Information

Michelle Wise, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland; Bridget Kool, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland; Lynn Sadler, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland; Roshini Peiris-John, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland; Gillian Robb, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland; Susan Wells, Epidemiology and Biostatistics, School of Public Health, FMHS, University of Auckland, Auckland.

Acknowledgements

Prof Peter Stone and A/Prof John Buchanan for having the foresight to embed QI teaching in the undergraduate medical curriculum at University of Auckland; Michelle Carvalho for her ongoing administrative support of the medical students in the Department of Obstetrics and Gynaecology; Faith Mahony for her assistance in conducting the 2014 formal evaluation of the QI programme; and Year 6 medical students Prasadi Jayasinghe and Cathy Zhong, on whose 2014 clinical audit project formed the example provided in the paper.

Correspondence

Dr Michelle R Wise, Senior Lecturer, Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142.

Correspondence Email

m.wise@auckland.ac.nz

Competing Interests

Dr Wells reports grants from Health Research Council of New Zealand, grants from National Heart Foundation of New Zealand, grants from The Stevenson Foundation, grants from Roche Diagnostics Ltd, outside the submitted work.

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