Integrating improvement competencies into residency education: a pilot project from a pediatric continuity clinic

Ambul Pediatr. 2003 May-Jun;3(3):131-6. doi: 10.1367/1539-4409(2003)003<0131:iicire>;2.


Objective: The Accreditation Council for Graduate Medical Education (ACGME) requires residents to attain 6 core competencies. This article describes a model for integrating 2 of these competencies (practice-based learning and improvement and systems-based practice) into residency education and assesses the clinical outcomes achieved for patients.

Study design: An observational study with before-after comparisons.

Intervention: Pediatric faculty facilitated multidisciplinary improvement team meetings (which included 8 residents) and implemented an established improvement model to improve the selected clinical condition (immunizations).

Main outcome measures: The proportion of consecutive children who were up-to-date on DTP, polio, MMR, HIB, and hepatitis B vaccines by 24 months of age.

Results: The residents' improvement team successfully implemented 5 changes in the clinic process, which coincided with an increase in immunization rates for 2-year-olds during the 1-year study period. Clinic immunization rates increased from 60% at baseline to 86% at follow-up (P =.04).

Conclusion: This study suggests that it is feasible to integrate practice-based learning and improvement and systems-based practice into residency education while providing a valuable learning experience for residents and improving patient outcomes.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation
  • Child, Preschool
  • Clinical Competence
  • Competency-Based Education*
  • Continuity of Patient Care
  • Humans
  • Immunization / statistics & numerical data*
  • Internship and Residency / organization & administration*
  • Models, Educational*
  • North Carolina
  • Pediatrics / education*
  • Pediatrics / standards
  • Physician-Patient Relations
  • Pilot Projects
  • Program Evaluation
  • Software Design
  • Systems Integration
  • Total Quality Management*