Co-Learning Curriculum in Quality Improvement for Surgical Residents- Five-Year Experience from the University of Toronto.

OBJECTIVE We describe our five-year experience with a novel co-learning curriculum in quality improvement (CCQI) 1 for the largest reported cohort of surgical residents. The program introduces trainees to principles of quality improvement (QI) 2 and empowers them to complete collaborative projects with mentorship from faculty experts. DESIGN Each iteration consists of three interactive seminars. Residents are required to complete and present a QI project in the third seminar. To assess the impact of the program, graduates of the 2020-2021 iteration were surveyed using validated tools to examine changes in confidence and knowledge of QI principles. SETTING Department of Surgery, University of Toronto, Toronto, ON, Canada. PARTICIPANTS Participation ranged from 57 to 63 residents yearly, from diverse surgical disciplines including General Surgery, Plastic Surgery, Obstetrics and Gynecology, amongst others. Multiple small groups consisted of 4-6 residents from each speciality, mentored by a faculty lead from the same specialty. RESULTS Approximately 300 first-year surgical residents have participated in the CCQI since 2015, with over 60 completed QI projects. A total of 41(66%) and 51(82%) residents completed the survey in its pre- and post-course administration in 2020-2021, respectively. There was a significant increase in confidence scores with respect to describing a QI issue, building a team, and testing the change, amongst other aspects. There was also a statistically significant increase in mean knowledge scores for both scenarios of the Quality Improvement Knowledge Application Tool. 69% and 73% of residents reported “some improvement” in their knowledge, and confidence in applying QI principles to patient care, respectively. A majority of residents (73%) found the QI curriculum somewhat valuable, with 23% reporting it to be very valuable to their residency and future surgical career. CONCLUSIONS We describe successful long-term implementation of a novel co-learning curriculum in quality improvement. Residents derive value from this curriculum with a meaningful increase in confidence and knowledge of QI as an integral part of surgical practice.