Journal of General Internal Medicine

, Volume 26, Issue 2, pp 221–225

Teaching Internal Medicine Residents to Sustain Their Improvement Through the Quality Assessment and Improvement Curriculum

  • Julie Oyler
  • Lisa Vinci
  • Julie K. Johnson
  • Vineet M. Arora
Innovations in Medical Education

DOI: 10.1007/s11606-010-1547-y

Cite this article as:
Oyler, J., Vinci, L., Johnson, J.K. et al. J GEN INTERN MED (2011) 26: 221. doi:10.1007/s11606-010-1547-y



Although sustainability is a key component in the evaluation of continuous quality improvement (CQI) projects, medicine resident CQI projects are often evaluated by immediate improvements in targeted areas without addressing sustainability.


To assess the sustainability of resident CQI projects in an ambulatory university-based clinic.


During their ambulatory rotation, all second year internal medicine residents use the American Board of Internal Medicine’s Clinical Preventive Services (CPS) Practice Improvement Modules (PIM) to complete chart reviews, patient surveys, and a system survey. The residents then develop a group CQI project and collect early post data. Third year residents return to evaluate their original CQI project during an ambulatory rotation two to six months later and complete four plan-do-study-act (PDSA) cycles on each CQI project.


From July 2006 to June 2009, 64 (100%) medicine residents completed the CQI curriculum. Residents completed six group projects and examined their success using early (2 to 6 weeks) and late (2 to 6 months) post-intervention data. Three of the projects demonstrated sustainable improvement in the resident continuity clinic.


When residents are taught principles of sustainability and spread and asked to complete multiple PDSA cycles, they are able to identify common themes that may contribute to success of QI projects over time.


resident educationquality improvementsustainabilitypractice-based learning and improvementsystem-based practice

Supplementary material

11606_2010_1547_MOESM1_ESM.doc (24 kb)
Online Appendix 1(DOC 23 kb)
11606_2010_1547_MOESM2_ESM.doc (37 kb)
Online Appendix 2(DOC 37 kb)
11606_2010_1547_MOESM3_ESM.pdf (1 mb)
Online Appendix 3All lectures.Handout format (PDF 1046 kb)
11606_2010_1547_MOESM4_ESM.pdf (310 kb)
Online Appendix 3QAIC Toolkit (PDF 309 kb)

Copyright information

© Society of General Internal Medicine 2010

Authors and Affiliations

  • Julie Oyler
    • 1
  • Lisa Vinci
    • 1
  • Julie K. Johnson
    • 2
  • Vineet M. Arora
    • 1
  1. 1.Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Centre for Clinical Governance ResearchUniversity of New South WalesSydneyAustralia