Evaluation of the American society of hematology quality improvement training institute: Impact on learner quality improvement knowledge, confidence, and satisfaction

Abstract Background: The American Society of Hematology (ASH) Quality Improvement Training Institute (QITI) launched in March 2024 to build capacity among hematologists and hematology professionals to lead quality improvement (QI) efforts QITI comprised 7 total workshops (3 in-person and 4 virtual), monthly individualized coaching, and the implementation of two QI projects per team, engaging 26 learners across multidisciplinary teams representing 5 institutions. We describe the program's impact on learners' self-reported QI knowledge, confidence, and satisfaction over the 16-month training period. Methods: A prospective mixed-methods program evaluation was conducted using an abridged version of the Beliefs, Attitudes, and Skills in Confidence in QI (BASIC-QI) scale at baseline (Mar 2024), mid-program (Jan 2025), and program end (Jun 2025). BASIC-QI includes two subscales: a 9-domain QI knowledge scale (7-point Likert Strongly Disagree to Strongly Agree) and a 12-domain QI confidence scale (4-point Likert Not at all confident to Extremely confident). Program satisfaction was assessed at program end via web-based survey, examining learner overall satisfaction with the program, coach effectiveness, and learner beliefs about sustainment of QI project success and program impact on career. Analyses compared mean scores over time and explored differences by participation modality (in-person vs. virtual). Qualitative analysis of the learning objectives and overall experience was conducted using open-ended responses collected from program assessments. Results: Among learners with complete data on the QI knowledge assessments (69% response), average QI knowledge scores improved from 3.98 at baseline to 6.27 at program end (p.001), while QI confidence improved from 1.86 to 3.13 (p.001). Improvements were observed in both in-person and virtual cohorts, though gains were slightly higher among in-person learners (knowledge improvement: 2.42 vs. 2.04 p.001; confidence improvement: 1.39 vs. 1.03 p.01). The majority of knowledge gains (83%) and confidence gains (65%) occurred between baseline and mid-program assessment, corresponding with the program's focus on didactic learning and intensive coaching in the first phase of the program. Continued confidence growth during the latter half of the program aligned with increased learner autonomy and expanded scope of institutional QI work. Learners reported growth in QI knowledge particularly in the use of tools like the PDSA cycle and expressed enthusiasm for applying these skills within their institutions. They valued the program's structure, coaching, and sense of community, while also recommending clearer timelines, expectations, and more time for project implementation in future cohorts. Results from the program satisfaction survey (77% response) indicate a high level of satisfaction and strong perceived impact on QI skills and career development. Respondents agreed or strongly agreed that the program met their expectations, were satisfied overall, and would recommend QITI to colleagues, with satisfaction notably higher among in-person learners. For example, 77% of in-person learners strongly agreed they would recommend QITI, compared to only 14% of virtual learners (with the remainder agreeing). Respondents reported high satisfaction with their coaches, with 75% strongly agreeing that coaches were knowledgeable, supportive, and provided constructive feedback. Respondents overwhelmingly agreed that QITI improved their competence and confidence in conducting QI, with 90% agreeing or strongly agreeing that QITI helped advance their careers in QI.Conclusions: ASH QITI significantly improved learners' self-reported QI knowledge and confidence. Early structured learning drove initial knowledge acquisition, while continued project engagement supported sustained growth in confidence. Findings suggest QITI effectively enhanced learners' QI skills and professional development, with greater perceived impact among in-person attendees. These findings support the value of structured, longitudinal QI training and coaching in hematology, and emphasize the potential benefit of in-person participation for maximizing engagement and program effect. Longer term evaluation is needed to validate gains in QI knowledge and confidence, assess QI project sustainability and development of future QI projects, and understand overall impact on alumni long-term career trajectory.