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Does QI training in primary care make a difference?

Q member, Heather Shearer shares her work with colleagues at NHS Education for Scotland, evaluating the delivery of QI training in primary care at scale.

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Primary care is highly pressured environment to work in and teams are keen to maintain, develop and improve service delivery. From a manpower and self-employed contract perspective, finding access to local quality improvement training and support has been more challenging than other parts of the health system.

Over two years we have delivered an introductory QI training programme to 260 primary care colleagues – 210 GPs – all over Scotland. Using Kirkpatrick’s framework, Dr Duncan McNab and colleagues at NHS Education for Scotland have evaluated the impact of the programme. This piece summarises briefly what seems to be working and why we think it is.

What our programme includes

  • Six online sessions of 90 minutes covering key quality improvement approaches, tools and techniques.
  • Cohorts of around 25.
  • Each learner applies the learning to a problem.
  • Expectation that some participants share progress at each session and everyone participates actively in the sessions.
  • Online space for recorded sessions and associated materials for participants.
  • Expectation of a final report and poster to be submitted.
  • Completing a reflective learning journal suggested after each session.

The evaluation tells us our learners enjoy the programme (93% would recommend it to their peers), report increased confidence and knowledge in applying quality improvement tools (we saw improvements in self-reported knowledge, confidence and attitudes across nine measures) and applied the learning to make a difference (94% of 102 projects demonstrated successful application of QI methods).

…the focus of the project is up to the individual learner so they can choose a topic that matters to them and their practice.

We think key contributing factors to these successes are…

  • The inclusion of specific primary care examples into the learning material.
  • Partnership delivery between a GP and a QI trainer.
  • Funding available for GPs to cover 10 sessions.
  • Requirement to do a live project – the focus of the project is up to the individual learner so they can choose a topic that matters to them and their practice.
  • Expectation to submit a project report/poster as a means to secure the funding.
  • We work hard to establish and maintain a positive, safe and fun learning environment for participants.

Things we’d like to work further on

  • Connecting with each other for mutual support and encouragement.
  • Follow-up to support ongoing application of tools and methods.
  • Further work on measurement of the programme.

Are you working to support people in primary care to apply quality improvement projects? What would you advise us next? How might we share and improve together?

Acknowledgements and authorship:

My key collaborators within NHS Education for Scotland on this are not (yet!) Q members but this blog is part of our agreed plan to share and learn from our work. We have jointly written this blog. Dr Duncan McNabb led the evaluation; myself, Dr Robert Duncan and Dr Nico Grunenberg delivered the training. The programme was funded by NHS Education for Scotland.

Do you have insight to share or want to find out more about this work? Leave a comment below or get in touch with Heather.


  1. Good work, interesting to read about your progress.
    I teach QI to GPs in Wales & absolutely agree that Primary care specific examples bring the methodology to life.  Mentoring sessions 1:1 after training for project support is productive, QI networking & showcasing events. My personal experience is that MDT training & mentoring in QI is more effective than training individuals- “ QI is a team sport”! - resource is the issue here - very happy to discuss more.



    1. Hi Sue. Thanks for your thoughts. I agree, mentoring/coaching sessions really help with the application of methods and tools. And yes, if resourcing makes it possible for a team to learn and apply together then that is really powerful. Have you managed to make those conditions happen in primary care? And any tips for encouraging busy/shy/unconfident folks to share their work in networking/showcasing events?

  2. Hi Heather - thanks so much for sharing learning from this work. You may already have seen, but this project funded through Q Exchange have some really interesting learning on evaluating QI training, which may provide useful insights for your further work on measurement

    1. Guest

      Charlotte Sharp 11 months ago

      Hi Jo

      Thanks for flagging this project which looks great! Please could you direct me to the outcomes for this project? Apologies if I missed it, but I couldn't see the findings and would be keen to use the evaluation framework. Many thanks


  3. Hi Charlotte - learning was shared in a webinar with the Evaluation Special Interest Group here I'm sure the team would welcome you getting in touch!


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