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Innovating QI Education – QuESt: Quality Improvement Engagement through Storytelling

Developing an on-demand, online series of animated tutorials using a story-telling adventure to raise awareness and understanding of Quality Improvement

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  • Proposal
  • 2022

What is the challenge your project is going to address and how does it connect to the theme?

Do things stop you giving great care? Does this frustrate you? Can you do something about it? This final question is where often QI fits in, but for people new to QI, getting started is often quoted as the hardest part. Despite traditional modes of capability building, the pandemic has necessitated a disruptive change to the delivery of education with 53% of all new educational development initiatives being transferred to an online delivery system.

Feedback from face-to-face and virtual workshops with hundreds of medical trainees suggested a QI-resource gap for easy to access, on demand, digestible digital materials which allow learning in a less structured environment.  There are materials available covering different QI-topics online nonetheless, there is no clear overarching process for improvement shared; leaving learners to make sense of the loosely connected set of resources available. We aim to teach an improvement process using a more immersive and gamified storyline.

What does your project aim to achieve?

We aim to develop a series of online-linked tutorials, accessible anytime by anyone which will teach a process for solving a problem rather than teaching unconnected principles and tools. All of this will be done through an adventure-based storyline to allow a deeper learner experience, complementing more formal QI teaching.

This access to standardised materials through bite-sized videos, will begin to “raise the floor” of QI capability for medical trainees, ensuring that they are able to support their own self-learning and self-development. This will help enhance the learners experience when they attend other facilitated sessions or participating in mentor-supported projects.

There will be an emphasis on the hidden curriculum items such as the importance of teamwork, communicating your QI work and the common pitfalls when you start. Furthermore, there will be some guidance and signposting to educational curricula and sign off for improvement at end of year ARCP for trainees.

How will the project be delivered?

We will use a QI approach to deliver the project at hand:

Understand:

  • Gather further feedback from medical trainees on requirements of QI training to ensure the user requirements are suitable.

Design:

  • Identify a digital partner to support creation of tutorials.
  • Design an initial set of 8-10 linked video tutorials over a 12-month period covering QI topics using an adventure island story telling theme. This will not be an exhaustive set of videos in the first instance; part of the project will be about signposting trainees to resources and further reading that address initial knowledge gaps.

Deliver:

  • Evaluate the impact of the initial set of video animations through user group feedback to inform content development and future direction

Sustain:

  • Widely disseminate findings of the pilot on Q Exchange, RCP Medical Care – Driving Change portal, and other education and quality improvement forums

How is your project going to share learning?

We endeavor to share learning through the Q Community website, especially through the ‘virtual learning’ special interest groups, as well as by presenting our work at improvement & educational forums and conferences including the RCP M conference 2023.

In addition, we aim to utilise social media such as #QITwitter to share the learning as well as the outputs from the project. The evaluation of the tutorials will form the basis of a journal article which also be written up in a medical educational journal.

Once this has been tested with medical trainees, the aim is to iterate the content over time to reach a wider audience

How you can contribute

  • Gap? - Do you feel there is an appropriate gap in QI education to warrant this development
  • Where do we start? - To demonstrate proof of concept and get important feedback from learners, do we
  • i) go through a step-by-step approach from the beginning, with future videos to follow or
  • ii) create a small sample of videos showing a breadth of the critical steps of improvement, leaving gaps to fill in at a later date?
  • Core principles? - From the Q community, it would be great to see what you feel would be the core set of subjects for the animation videos
  • Previous Experience? - Has anyone embraced story telling in their improvement work or as a learning tool? And if so, how did you go about it?
  • Investment? – Do you have any suggestions on where we could identify further funding to complete the full set of tutorials?

Plan timeline

30 May 2022 Stage 1 – Define the problem
9 Sep 2022 Stage 3 - Visioning and goal setting (including milestones)
26 Sep 2022 Stage 2 – Current situation (End user session and identify digital partner)
30 Sep 2022 Stage 4/5 – Analysis and development of requirements
25 Nov 2022 Stage 6 – Experimentation – First Video to be developed
16 Jun 2023 Stage 6 – Experimentation – Final video to be developed
16 Jun 2023 Stage 7 – Monitoring progress and sharing learning/Evaluation
29 Sep 2023 Stage 8 – Celebrating Success

Comments

  1. Guest

    Elizabeth.Bradbury 3 months, 1 week ago

    Great idea and very thorough proposition. Learning would be highly relevant to multiple professional and vocational learning environments. Re your questions:

    Gap? - Do you feel there is an appropriate gap in QI education to warrant this development•  Yes.

    Where do we start? - To demonstrate proof of concept and get important feedback from learners, do we
    ii) create a small sample of videos showing a breadth of the critical steps of improvement, leaving gaps to fill in at a later date? Yes, keep it simple and high level at the start, rather than gaps perhaps think about complexity, you can drill down if you want to  e.g. 3-minute and 30-minute options
    • Core principles? - From the Q community, it would be great to see what you feel would be the core set of subjects for the animation videos. Juran Trilogy, intro to model for improvement and lean as a minimum. For this audeince perhaps more on a) measurement for improvement v performance v research and b) human angle of change, how to infleunec and engage people who may be more senior than you and c) partnering with service users to ensure voice of customer is central to all QI
    • Investment? – Do you have any suggestions on where we could identify further funding to complete the full set of tutorials? HEE regional or national; royal colleges; might the AHSN network be interested as a route to potential technical partners?

    Good luck!

    1. Guest

      Thanks Elizabeth

      What we are finding is a wide spectrum of understanding about change and improvement in doctors during the early stages of their career. There are some great examples of support, especially the TIPS programme in the NW and a number of exemplar trusts. Many however are inadequately supported, and have a curriculum requirement. Sometimes these programmes or support come "too late" when some of the misconceptions about implementing improvement have been reinforced through experience. This also creates a negative experience for some. We know it should be a positive experience that influences their whole career.  So we want to create an accessible resource that explores the basics of improvement to get doctors in the early stage of their careers going in the right direction, and signposting them to more detailed support as they progress.

      While it is focussed initially on doctors in the early stage of their careers it will certainly be useful across professions and could rapidly develop in that way. Indeed many professionals in healthcare are now getting improvement experience in their undergraduate years.

      Thanks for your inciteful guidance as ever

    2. Hi Elizabeth, thanks for your feedback! Really helpful and was something I hadn't thought of re: complexity options re: 3min vs 30 min tutorials. Defintiely something to take away and think about. I think the suggestions are solid as well and were along the lines we were thinking.

      Do you know anyone HEE or AHSN-wise who might be good to talk about this?

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