A Quality Improvement Project to Improve the Education Curriculum of a Pediatric Residency Program

Purpose/Objectives: Continuous improvement of an education curriculum is required to meet resident needs and ensure the success of pediatric residents. From 2013-2017, we noted opportunities for improvement in our education curriculum compared to national averages on the Accreditation Council for Graduate Medical Education (ACGME) surveys. Anecdotally, residents reported opportunities for improvement in consistency, faculty attendance, and applicability of the sessions. A resident-led quality improvement group was developed with a global aim to improve resident education. Our SMART aim was to improve our curriculum to meet and/or exceed national mean scores in educational content on the annual ACGME survey over 3-4 years.

Design/Methods: The Education QI Team was formed in October 2017 and consisted of pediatric residents and faculty eager to improve the education curriculum at our pediatric residency program. The team targeted areas requiring improvement in the residency curriculum based on feedback and focus groups (see Key Driver Diagram Figure 1). Strategies for improvement were formulated including weighting education sessions based on the ABP General Pediatrics Board Exam Content Outline, improving scheduling and reminders for faculty and residents regarding sessions, developing clear expectations for each session, and enhancing our simulation curriculum (Figure 1). Our key outcome measure was average score in educational content on the annual ACGME survey. Process measures included 5 question surveys to assess resident satisfaction with particular sections of the curriculum (example simulation, core discussion series, and board review). The group met regularly to review measures and tests of change (Figure 2). Balancing measures included pediatric board first time passing rates and in-training exam scores to ensure they remained stable and/or improved.

Results: The ACGME survey results demonstrated an improvement in resident rating of the educational content domain since the initiation of the Education QI group (Figure 2). Serial surveys completed by residents in each PDSA cycle further illustrated improvement after the implementation of numerous interventions targeting the enhancement of the education curriculum. In the most recent survey, there was an upward trend in satisfaction with changes made to the board review curriculum, simulation curriculum, and core discussion series.

Conclusion/Discussion: Enacting several changes under the guidance of a resident-led quality improvement group unified on enhancing the education curriculum in their pediatric residency program resulted in increased mean educational content scores in the ACGME survey above the national mean over the last 4 years. Next steps include education on test taking strategies, increased case-based simulation scenarios, and periodic testing of knowledge gaps.