Understanding the State of Quality Improvement Education for Pediatric Infectious Diseases Trainees
Year: 2023
Type: article
Study design: Observational Study
Abstract: To the editor, Quality Improvement (QI) training and experience are mandated by the Accreditation Council for Graduate Medical Education for all physician trainees [1], but descriptions of QI training programs for subspecialty fellows are limited [2]. While relevant for all specialties, these skills are particularly useful in infectious diseases. For example, the Infectious Diseases Society of America (IDSA) emphasizes QI concepts such as process and outcome measures in antimicrobial stewardship [3]. To our knowledge, no publications describe the current state of QI education for pediatric infectious disease (PID) trainees. To better understand the current landscape and gauge interest in a potential QI training curriculum that could be offered through the Pediatric Infectious Diseases Society (PIDS), we surveyed PID program directors (PDs) in November 2022 through the official PIDS listserv. Question domains included high-level program demographics, local QI training opportunities, expectations around QI work products, and interest in a national curriculum. The survey was built in a secure REDCap (Research Electronic Data Capture, Vanderbilt, TN) [4] database. No identifying information was captured. This study was deemed exempt from full review by our local Institutional Review Board. Twenty-nine percent (20/69) of PDs responded (Table 1). Of responding programs, six (30%) have a formal QI training program for their fellows; the remainder does not. Fifteen (75%) PDs reported institution-run QI learning opportunities available outside of the fellowship program, 3 (15%) stated there are none, and 2 (10%) were not sure. Eighty-three percent (5/6) programs with fellowship-level training also have institutional-level training available. Of programs with no formal QI training within their fellowship, five require fellow participation in institutional QI training programs. Fifteen (75%) programs require fellows to participate in a QI project; of those, 5 required fellows to be the project leader. All respondents expressed interest in a national QI training program for fellows. Demographics of responding programs Demographics of responding programs The fact that just under half of responding fellowship programs do not include formal QI training suggests a need for increased access to QI training resources. This need is not unique—PDs in other specialties also desire trainee QI teaching resources through their national society [5], and over three fourths of IDSA physicians reported interest in IDSA-provided QI resources [6]. Programs face many barriers to QI training. They are expected to cover many educational domains beyond clinical training [1]. Additionally, the lack of faculty with QI experience is a previously identified barrier [5]; this problem could self-perpetuate if trainees continue to graduate without robust QI training. While institutional-level QI programs are a potential workaround, this option is not universally available and the structure may not be optimal for clinical trainees [7]. Although the response rate limits this study, the universally positive responses suggest a national curriculum would be valuable. Additionally, more information is needed about fellow participation in nonmandatory hospital-wide QI training programs and outcomes (eg, the proportion ultimately using QI skills after graduation). Ultimately, we identified a need for additional high-quality QI education opportunities for PID trainees. To begin to address this gap, our next steps will include additional evaluation of barriers and development of a curriculum with local piloting and plans for eventual widespread dissemination. The authors would like to thank the Pediatric Infectious Diseases Society Training Programs Committee for their assistance in survey distribution.
Institutions: Northwestern University, Lurie Children's Hospital
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4322718401