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01.09.2007 | Original Article | Ausgabe 9/2007

Journal of General Internal Medicine 9/2007

Validation of a Method for Assessing Resident Physicians’ Quality Improvement Proposals

Zeitschrift:
Journal of General Internal Medicine > Ausgabe 9/2007
Autoren:
MD James L. Leenstra, MD Thomas J. Beckman, MD, MPH Darcy A. Reed, MD William C. Mundell, MD Kris G. Thomas, MD Bryan J. Krajicek, MS Stephen S. Cha, MD Joseph C. Kolars, MD MPH Furman S. McDonald
Wichtige Hinweise
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.

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.

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