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Validation of a Method for Assessing Resident Physicians’ Quality Improvement Proposals
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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. McDonald2 
| (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.
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