417 - Pediatric Residency Academic Rotation Improves Self-Rated Proficiency in Quality Improvement Skills

Poster Number: 417
Publication Number: 417.445

Maria Heubeck, University of New Mexico Children's Hospital, Albuquerque, NM, United States; Rebecca Craig, University of New Mexico Children's Hospital, Albquerque, NM, United States; Lanier Lopez, University of New Mexico School of Medicine, Albuquerque, NM, United States; Elizabeth Y. Jimenez, University of New Mexico Health Sciences Center, Albuquerque, NM, United States

Background: ACGME states that all residents must be involved with quality improvement (QI) activities during their training. In program surveys at the University of New Mexico, pediatric residents were not satisfied with opportunities for involvement in scholarly activity. In response, our program developed a mandatory academic rotation.

Objective: As of July 2020, all second-year pediatric residents participate in a one-month academic rotation. The rotation focuses on QI, research, education and leadership skills and experience. This project aims to assess the impact of the rotation on residents' self-reported QI proficiency, self-rated motivation to pursue scholarly activities, and competency based on ACGME milestones.

Design/Methods: Pediatric residents participating in the academic rotation from July 2020 to December 2021 were invited via e-mail to complete pre-, immediate post-rotation, and six months post-rotation surveys in REDCap. We conducted Wilcoxon signed-rank test in Stata/SE 15 to compare responses to the pre-, immediate, and six months post surveys for residents who completed both surveys (n=9 immediate post; n=5 six months post). Self-reported proficiency in QI skills were measured on a scale from 1-not proficient to 5-very proficient.

Results: The majority of residents identified as female (58%) and white (58%) and 42% identified as Hispanic or Latino/a. Overall, residents reported an increase in their perceived QI proficiency across all 12 measures, with a statistically significant pre-to-immediate post increase in median score for nine measures. The biggest pre-to-immediate post improvements were observed for: "identify outcome and process measures appropriate for a quality problem" (Pre median: 2.5; Post: 4; p=0.008) and "identify changes in practice to improve processes and outcomes" (Pre: 2.5; Post 4; p=0.011). Patterns of improvement were generally maintained at 6 months post, although values were no longer significantly different from baseline, with evidence of score regression for some items. This may be attributable to loss to follow-up/small sample size or changing perceptions of proficiency as the residents continue to apply the skills.Conclusion(s): The academic rotation offers a unique opportunity for residents to focus on their scholarly skills. This preliminary, short-term evaluation from the initial implementation indicates that residents perceive an improvement in their QI skills during the rotation, but more support may be needed to maintain and continue to develop skills after the rotation ends. This evaluation will continue as more residents engage with the academic rotation.
Residents' Self-Rated ProficiencyResidents' Self-Rated Proficiency in QI skills, pre- and post-rotation
ScaleSelf-Reported Proficiency Scale