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Original Article

Validation of a Method for Assessing Resident Physicians’ Quality Improvement Proposals

James L. Leenstra1, Thomas J. Beckman2, Darcy A. Reed3, William C. Mundell2, Kris G. Thomas3, Bryan J. Krajicek1, Stephen S. Cha4, Joseph C. Kolars5 and Furman S. McDonaldContact Information

(1)  Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
(2)  Division of General Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
(3)  Division of Primary Care Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
(4)  Division of Biostatistics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
(5)  Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA

Received: 20 December 2006  Revised: 3 May 2007  Accepted: 4 June 2007  Published online: 30 June 2007

Abstract
BACKGROUND  Residency programs involve trainees in quality improvement (QI) projects to evaluate competency in systems-based practice and practice-based learning and improvement. Valid approaches to assess QI proposals are lacking.
OBJECTIVE  We developed an instrument for assessing resident QI proposals—the Quality Improvement Proposal Assessment Tool (QIPAT-7)—and determined its validity and reliability.
DESIGN  QIPAT-7 content was initially obtained from a national panel of QI experts. Through an iterative process, the instrument was refined, pilot-tested, and revised.
PARTICIPANTS  Seven raters used the instrument to assess 45 resident QI proposals.
MEASUREMENTS  Principal factor analysis was used to explore the dimensionality of instrument scores. Cronbach’s alpha and intraclass correlations were calculated to determine internal consistency and interrater reliability, respectively.
RESULTS  QIPAT-7 items comprised a single factor (eigenvalue = 3.4) suggesting a single assessment dimension. Interrater reliability for each item (range 0.79 to 0.93) and internal consistency reliability among the items (Cronbach’s alpha = 0.87) were high.
CONCLUSIONS  This method for assessing resident physician QI proposals is supported by content and internal structure validity evidence. QIPAT-7 is a useful tool for assessing resident QI proposals. Future research should determine the reliability of QIPAT-7 scores in other residency and fellowship training programs. Correlations should also be made between assessment scores and criteria for QI proposal success such as implementation of QI proposals, resident scholarly productivity, and improved patient outcomes.

KEY WORDS  quality improvement - systems-based practice - practice-based learning and improvement - assessment - evaluation study - validation study

Study findings were presented at the Association of Medical Education in Europe Annual Meeting, Genoa, Italy, September 14–18, 2006 and at the ABMS/ACGME Joint Conference on Assessing and Improving Patient Care, Rosemont, L, November 2–3, 2006.

Contact Information Furman S. McDonald
Email: mcdonald.furman@mayo.edu
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Referenced by
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  1. Wittich, Christopher M (2010) Validation of a method to measure resident doctors’ reflections on quality improvement. Medical Education 44(3)
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  2. Colbert, Colleen Y. (2009) Students learn systems-based care and facilitate system change as stakeholders in a free clinic experience. Advances in Health Sciences Education
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  3. Patow, Carl A. (2009) Residentsʼ Engagement in Quality Improvement: A Systematic Review of the Literature : . Academic Medicine 84(12)
    [CrossRef]
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