Pediatric resident education in quality improvement (QI): a national survey

Acad Pediatr. Jan-Feb 2014;14(1):54-61. doi: 10.1016/j.acap.2013.10.004.


Objective: To assess pediatric residents' perceptions of their quality improvement (QI) education and training, including factors that facilitate learning QI and self-efficacy in QI activities.

Methods: A 22-question survey questionnaire was developed with expert-identified key topics and iterative pretesting of questions. Third-year pediatric residents from 45 residency programs recruited from a random sample of 120 programs. Data were analyzed by descriptive statistics, chi-square tests, and qualitative content analysis.

Results: Respondents included 331 residents for a response rate of 47%. Demographic characteristics resembled the national profile of pediatric residents. Over 70% of residents reported that their QI training was well organized and met their needs. Three quarters felt ready to use QI methods in practice. Those with QI training before residency were significantly more confident than those without prior QI training. However, fewer than half of respondents used standard QI methods such as PDSA cycles and run charts in projects. Residents identified faculty support, a structured curriculum, hands-on projects, and dedicated project time as key strengths of their QI educational experiences. A strong QI culture was also considered important, and was reported to be present in most programs sampled.

Conclusions: Overall, third-year pediatric residents reported positive QI educational experiences with strong faculty support and sufficient time for QI projects. However, a third of residents thought that the QI curricula in their programs needed improvement, and a quarter lacked self-efficacy in conducting future QI activities. Continuing curricular improvement, including faculty development, is warranted.

Keywords: education; effectiveness; pediatrics; quality improvement; resident; self-efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Curriculum* / standards
  • Humans
  • Internship and Residency* / organization & administration
  • Internship and Residency* / standards
  • Organizational Culture
  • Pediatrics / education*
  • Physicians / psychology
  • Quality Improvement*
  • Self Efficacy
  • Surveys and Questionnaires