Teaching Quality Improvement to Internal Medicine Residents to Address Patient Care Gaps in Ambulatory Quality Metrics

A s quality improvement (QI) has become an integral part of clinical practice, residency training programs have continued to evolve in how best to teach QI. The Accreditation Council for Graduate Medical Education (ACGME) Common Program requirements mandate that core competencies in residency programs include practice-based learning and improvement and systems-based practice. 1 Residents should receive education in QI, receive data on quality metrics and benchmarks related to their patient population, and participate in QI activities. The Clinical Learning Environment Review (CLER) program was established to provide feedback to institutions on 6 focused areas, including patient safety and health care quality. In visits to institutions across the United States, the CLER committees found that many residents had limited knowledge of QI concepts and limited access to data on quality metrics and benchmarks. 2 There are many barriers to implementing a QI curriculum in residency programs, and creating and maintaining successful strategies has proven challenging. 3 Many QI curricula for internal medicine residents have