Students add value to learning organizations: the Medical University of South Carolina experience.

Students bring fresh ideas, knowledge, and perspective to health care organizations. As students learn how to apply the principles and methods of continuous improvement, they help improve both the quality of health care and the organization's way of improving quality.

Organizational environment and perceptions of teaching quality in seven South Carolina family medicine residency programs.

PURPOSE: To explore the relationship between organizational environment and teaching quality in seven family medicine residency programs. METHOD: In 1995, a questionnaire on organizational environment was administered to the faculties at all seven family medicine residency programs in South Carolina. Eighty-seven percent of the faculty members participated, as did convenience samples of residents, nurses, and administrative staff. The questionnaire measured seven variables: teaching quality, job satisfaction, organizational climate, employees' autonomy, goal attainment, organizational commitment, and job-related stress. RESULTS: Residents, nurses, and administrative staff who were connected to programs at which faculty expressed high levels of job satisfaction assessed teaching quality as higher than did those at other programs. The residents' perceptions of teaching quality were positively correlated with high ratings of organizational climate and job-related stress. The staffs' ratings of goal attainment were also associated with teaching quality. Faculty satisfaction was associated with their reported employee autonomy and goal attainment. CONCLUSION: The organizational characteristics of family medicine residency programs significantly influence the perceptions of teaching quality: specifically, there perceptions are correlated with the degree to which faculty are satisfied with their work environments. In addition, residents' and staffs' perceptions of teaching quality are associated with their attitudes toward their organizations' environments.

The PDSA cycle at the core of learning in health professions education.

BACKGROUND: The Plan-Do-Study-Act (PDSA) cycle lies at the heart of continuous improvement and is a redefinition of the scientific method for application to the world of work. HEALTH CARE AS A CONTEXT FOR HEALTH PROFESSIONS LEARNING: Educational institutions could create the best "quality learning" environments for students by relating closely to health care organizations that create improvement environments for workers. When both become "learning" organizations and develop a relationship with each other, an important product will be the integration of processes for individual and organizational learning. THE PDSA CYCLE AS LEARNING THEORY: The PDSA cycle can be an integrating theory for both individual and organizational learning. It shares basic features of well-accepted theory about individual and organizational learning, including the concepts of change and action/reflection. EVALUATING LEARNING THROUGH PDSA CYCLES: An illustration is given of one set of implications of the PDSA cycle as learning theory. It describes an alternative way of thinking about the evaluation of learning, which surpasses the traditional emphasis on judgment in evaluation. CONCLUSIONS: The potential to place the PDSA cycle at the core of learning in health professions education is great. Contributing factors to this potential include the historical emphasis on the scientific method in health care, the relationship between clinical education and practice, recent improvements in our capacity to define and measure health outcomes, emergent pressures for change in health care and education, and compatible multiple functions of the PDSA cycle.

Policies of U.S. medical schools on the use of the NBME Part I and Part II examinations.

The study reported here provides information on National Board of Medical Examiners (NBME) examination policies from all U.S. medical schools (n = 67) that require students to pass the examination. Most of these schools have similar policies on use of a 380 total score as the passing level for the NBME Part I examination, allowing three attempts to pass the examination, interrupting a student's progress into the clinical curriculum upon failure of the examination, officially providing time for preparation for taking the test, and requiring students to pass the Part II examination.