Background: Residency programs have emphasized inpatient training, focusing primarily on clinical skill development through managing patients during acute illness. Long-term outpatient management and preventive care have gained recognition as essential components of medical education within the past decade and residency programs now actively incorporate structured outpatient training into their educational frameworks. Problem: During the 2024 annual resident evaluation, the Education Committee identified that the clinic rotation was primarily service-based, with no structured educational activities in 2023-2024. The lack of learning opportunities negatively impacts both resident education and the quality of patient care over time. A resident survey revealed only 30% satisfaction with the clinic rotation. The most common concern was that the lack of teaching activities made it a less productive rotation, impacting residents' morale and compromising the quality of patient care. Aim: By March 31, 2025, the program will implement and sustain daily structured teaching sessions, with the aim of achieving 80% attendance by residents and fellows and at least 50% by attending physicians. Additionally, we aim to improve resident satisfaction with the educational sessions to 65% by March 31, 2025. Method: This project was implemented in resident clinics within an academic tertiary care center, involving 46 pediatric residents who attended the clinic an average of twice per month. We developed and implemented a structured educational curriculum using the Model for Improvement and PDSA cycles. The intervention consisted of 30-minute educational sessions incorporated into the clinic workflow, which either fellows or attending physicians supervised. The sessions were held regularly and were adjusted based on resident feedback collected every three months. The intervention was carried out in three PDSA cycles from July 2024 to March 2025. Results: Over the course of three PDSA cycles, steady improvements were observed in resident engagement and satisfaction. Resident attendance at educational sessions reached 62%, 65%, and 68% in the three PDSA cycles, respectively. As measured by surveys, resident satisfaction improved markedly from an initial 30% to 90%, 91%, and 93% respectively. 5-7% of residents did not complete the satisfaction surveys during each cycle. These outcomes suggest that structured educational interventions can enhance both the learning environment and resident engagement in outpatient settings. Conclusion: This initiative successfully addressed a critical gap in outpatient residency training. The introduction of 30-minute structured educational sessions into the outpatient clinic workflow enhanced the learning experience for pediatric residents. Throughout the PDSA cycles, we observed significant and sustained increases in both attendance and satisfaction, indicating a clear demand and appreciation for dedicated teaching time. The success of this project highlights the impact of educational interventions that can be adapted to similar clinical training environments. As the next step, efforts will focus on sustaining these changes and exploring the long-term effects on clinical competence and patient outcomes.
Abbasi et al. (Thu,) studied this question.