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Acad Pediatr. 2018 Oct 24. pii: S1876-2859(18)30743-5. doi: 10.1016/j.acap.2018.10.006. [Epub ahead of print]

Pediatric Residents' Reports of Quality Improvement Training and Experiences: Time for an Improvement Cycle?

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Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine; Cincinnati, Ohio. Electronic address:
The American Board of Pediatrics, Chapel Hill, NC; Tufts School of Medicine; Boston, Massachusetts.
Child Health Evaluation and Research Center; University of Michigan; Ann Arbor, Michigan.



Explore pediatric residents' experiences and confidence with quality improvement (QI).


Pediatric residents were surveyed nationally in July 2017 about their demographic characteristics, experiences with QI projects over the previous year, and confidence with QI skills. Descriptive statistics and distributions of each individual demographic and QI variable, as well as training program size, were calculated for each variable. QI question responses were compared to demographic characteristics of the respondents and chi-square statistics were calculated.


11,137/11,304 (98.5%) residents completed the survey. Half of residents had participated in a QI project over the previous academic year, with 78% of 3rd year residents reporting having done so. However, few of these residents self-reported "moderate or high confidence" in their ability to design a QI project (28.9%), use QI tools (23.1%), use QI methodologies (24.0%), or use data to track changes in their personal practice over time (28.9%). Residents in small or medium programs were statistically more likely to rate their confidence in certain QI abilities higher than those in large programs.


While recent pediatric residents appear to be participating in QI activities during training, their self-perception of their QI skills development remains low. Residents in small and medium programs provide more favorable reports.


Graduate medical education; Quality improvement


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