Pediatric Residents' Reports of Quality Improvement Training and Experiences: Time for an Improvement Cycle?

Acad Pediatr. May-Jun 2019;19(4):399-403. doi: 10.1016/j.acap.2018.10.006. Epub 2018 Oct 25.


Objective: Explore pediatric residents' experiences and confidence with quality improvement (QI).

Methods: Pediatric residents were surveyed nationally in July 2017 about their demographic characteristics, experiences with QI projects over the previous year, and confidence with QI skills. Descriptive statistics and distributions of each individual demographic and QI variable, as well as training program size, were calculated for each variable. QI question responses were compared to demographic characteristics of the respondents, and chi-square statistics were calculated.

Results: In total, 11,137 out of 11,304 (98.5%) residents completed the survey. Half of residents had participated in a QI project over the previous academic year, and 78% of third-year residents reported having done so. However, few of these residents self-reported moderate or high confidence in their ability to design a QI project (28.9%), use QI tools (23.1%), use QI methodologies (24.0%), or use data to track changes in their personal practice over time (28.9%). Residents in small or medium programs were statistically more likely to rate their confidence in certain QI abilities higher than those in large programs.

Conclusions: Although recent pediatric residents appear to be participating in QI activities during training, their self-perception of their QI skills development remains low. Residents in small and medium programs provide more favorable reports.

Keywords: graduate medical education; quality improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Competence*
  • Education, Medical, Graduate / methods*
  • Female
  • Humans
  • Internship and Residency
  • Male
  • Pediatrics
  • Physicians / psychology*
  • Quality Improvement*
  • Surveys and Questionnaires
  • United States