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Acad Med. 2018 Dec;93(12):1784-1790. doi: 10.1097/ACM.0000000000002329.

How Theory Can Inform Our Understanding of Experiential Learning in Quality Improvement Education.

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1
J. Goldman is scientist, Centre for Quality Improvement and Patient Safety, and assistant professor, Department of Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. A. Kuper is associate professor, Department of Medicine, scientist and associate director, Wilson Centre for Research in Education, University Health Network, University of Toronto Faculty of Medicine, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. B.M. Wong is associate professor, Department of Medicine, University of Toronto Faculty of Medicine, associate director, Centre for Quality Improvement and Patient Safety, University of Toronto Faculty of Medicine, and staff physician, Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Abstract

It is widely accepted that quality improvement (QI) education should be experiential. Many training programs believe that making QI learning "hands-on" through project-based learning will translate into successful learning about QI. However, this pervasive and overly simplistic interpretation of experiential QI learning, and the general lack of empirical exploration of the factors that influence experiential learning processes, may limit the overall impact of project-based learning on educational outcomes.In this Perspective, the authors explore the opportunities afforded by a theoretically informed approach, to deepen understanding of the diverse factors that affect experiential QI learning processes in the clinical learning environment. The authors introduce the theoretical underpinnings of experiential learning more generally, and then draw on their experiences and data, obtained in organizing and studying QI education activities, to illuminate how sociocultural theories such as Billett's workplace learning theory, and sociomaterial perspectives such as actor-network theory, can provide valuable lenses for increasing our understanding of the varied individuals, objects, contexts, and their relationships that influence project-based experiential learning. The two theoretically informed approaches that the authors describe are amongst numerous others that can inform a QI education research agenda aimed at optimizing educational processes and outcomes. The authors conclude by highlighting how a theoretically informed QI education research agenda can advance the field of QI education; they then describe strategies for achieving this goal.

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