JMIR Publications

ABSTRACT

Background:

Quality improvement (QI) is essential to advancing patient care and safety. Despite regulatory expectations, medical curricula often lack structured and practical QI training. Involving learners in curriculum design has been shown to improve engagement and relevance, but co-designed QI education remains underexplored.

Objective:

This study aimed to develop and evaluate a co-designed, evidence-based educational model to improve learners’ knowledge, confidence, and engagement in audits and QI projects (QIPs).

Methods:

Using Kern’s six-step curriculum development model and Kolb’s Experiential Learning Theory, we co-designed a one-day QI conference with medical students and resident doctors. The programme incorporated expert-led lectures, interactive workshops, small-group activities, and peer presentations addressing audit methodology, ethics, and real-world implementation. A mixed-methods evaluation was conducted. Pre- and post-event surveys assessed changes in QI knowledge and confidence using 10-point Likert scales. Statistical analysis included Wilcoxon matched-pairs signed-rank and Fisher’s exact tests. Qualitative data from post-event interviews were analyzed thematically to capture participants’ experiences, skill development, and perceived barriers.

Results:

31 learners attended; 24 completed both pre- and post-event surveys. Statistically significant improvements were observed in understanding of QI concepts and confidence in QIP participation. For example, understanding of the PDSA cycle increased from a median of 2.0 (IQR 1.0–2.8) to 4.0 (IQR 4.0–5.0; p<0.0001), while confidence to engage in QIPs rose from 4.5 (IQR 2.3–7.0) to 7.5 (IQR 6.3–8.0; p=0.0035). Knowledge of additional methodologies, including Six Sigma, Lean, and root cause analysis, also improved significantly. Participants rated the programme highly (median score 9.5/10). Qualitative themes highlighted enhanced skills in project planning, ethical awareness, and motivation to apply learning in clinical practice. Identified challenges included limited institutional support, time pressures, and lack of resources. Organising students reported benefits in leadership, project management, and educational design.

Conclusions:

A co-designed, evidence-based educational model substantially improved learners’ QI knowledge, skills, and confidence, while fostering leadership opportunities for student organisers. Learner involvement enhanced the programme’s relevance and engagement, though it required structured facilitation to manage challenges. This scalable and resource-efficient model can help address current gaps in QI education and better prepare medical students and resident doctors to lead future improvement efforts. Broader implementation and longitudinal evaluation are recommended to sustain impact and embed QI as a core competency in medical training.