ABSTRACT
BACKGROUND: The Accreditation Council for Graduate Medical Education Clinical Learning Environment Review recommends that quality improvement/patient safety (QI/PS) experts, program faculty, and trainees collectively develop QI/PS education. OBJECTIVE: Faculty, hospital leaders, and resident and fellow champions at the University of Chicago designed an interdepartmental curriculum to train postgraduate year 1 (PGY-1) residents on core QI/PS principles, measuring outcomes of knowledge, attitudes, and event reporting. METHODS: The curriculum consisted of 3 sessions: PS, quality assessment, and QI. Faculty and resident and fellow leaders taught foundational knowledge, and hospital leaders discussed institutional priorities. PGY-1 residents attended during protected conference times, and they completed in-class activities. Knowledge and attitudes were assessed using pretests and posttests; graduating residents (PGY-3-PGY-8) were controls. Event reporting was compared to a concurrent control group of nonparticipating PGY-1 residents. RESULTS: From 2015 to 2017, 140 interns in internal medicine (49%), pediatrics (33%), and surgery (13%) enrolled, with 112 (80%) participating and completing pretests and posttests. Overall, knowledge scores improved (44% versus 57%, P < .001), and 72% of residents demonstrated increased knowledge. Confidence comprehending quality dashboards increased (13% versus 49%, P < .001). PGY-1 posttest responses were similar to those of 252 graduate controls for accessibility of hospital leaders, filing event reports, and quality dashboards. PGY-1 residents in the QI/PS curriculum reported more patient safety events than PGY-1 residents not exposed to the curriculum (0.39 events per trainee versus 0.10, P < .001). CONCLUSIONS: An interdepartmental curriculum was acceptable to residents and feasible across 3 specialties, and it was associated with increased event reporting by participating PGY-1 residents.
Subject(s)
Curriculum , Internship and Residency/methods , Patient Safety , Quality Improvement , Education, Medical, Graduate/methods , Educational Measurement , Female , Humans , Illinois , Male , Quality Assurance, Health Care/methodsABSTRACT
Resource allocation systems for higher education including funding formulas vary greatly with most models grounded in the traditional Arts and Sciences, that is, campus-based, large-classroom instruction. The implications for nursing, a clinical discipline, are monumental. Funding models in general use do not account for the requirements of nursing education related to clinical learning (vulnerable patients, liability, large number of contact hours in clinical laboratories). Little information related to funding issues in schools of nursing has appeared in nursing literature over the past 10 years, and there are limited data for administrators of nursing programs to use as benchmarks. Administrators in nursing education programs must acquire a better understanding of budget and finance systems in higher education at state and university levels. Likewise, nursing education leaders are challenged to collectively verify and clarify the unique needs of nursing education in the budget process and to become active in educating college and university administrators and state legislatures about these unique needs.
Subject(s)
Budgets/organization & administration , Education, Nursing, Baccalaureate/organization & administration , Nurse Administrators/organization & administration , Training Support/organization & administration , Decision Making, Organizational , Faculty, Nursing/organization & administration , Goals , Guidelines as Topic , Health Services Needs and Demand , Humans , Leadership , Models, Economic , Models, Educational , Nurse's Role , Organizational Innovation , Organizational ObjectivesABSTRACT
Critical thinking is frequently discussed in nursing education and nursing practice literature. This article presents an analysis of the concept of critical thinking as it applies to nursing, differentiating its use in education and practice literature. Three computerized databases (CINAHL, MEDLINE, and EBSCO) were searched for the years 1981 to 2002, using the keywords critical thinking. References were stratified into two 11-year periods (1981-1991, 1992-2002) to identify changes in the concept over time and integration of the concept differentially into nursing education and nursing practice. A random sample of literature from each stratum was coded for definitions, attributes, surrogate terms, referents, antecedents, and consequences of critical thinking. Critical thinking as a nursing concept has matured since its first appearance in the literature. It is well defined and has clear characteristics. However, antecedents and consequences are not well defined, and many consequences are identical to attributes and surrogate terms. Additional work is needed to clarify the boundaries of the concept of critical thinking in nursing.
