Integrating a Project-Based Learning Methodology into a Department-Wide Quality Improvement Curriculum: A Nine-Year Experience in Pediatric Subspecialty Training

Background: Quality improvement (QI) training of subspecialty fellows is an essential component of graduate medical education, yet often delivered in silos within departments through a variety of instructional methodologies. Objective: We applied project-based learning (PjBL) as a guiding methodology for a QI curriculum for pediatric subspecialty fellows and describe our curriculum development, instructional design, and its implementation. Methods: We integrated the Institute for Healthcare Improvement (IHI) Model for Improvement with the 6 key features of PjBL: a driving question, defined learning goals, active participation in educational tasks, collaboration among learners, scaffolding with learning technology, and production of tangible artifacts. The curriculum consisted of workshops followed by application of knowledge to clinical problems through QI projects carried out in their clinical areas. The impact of the curriculum was evaluated by sustainability of fellow-led projects and scholarly output. Results: From July 2014 through June 2023, 487 pediatric subspecialty fellows participated in 106 QI projects; 80 projects (75%) were sustained for at least 6 months and 65 (61%) were sustained 1 year or longer. Thirty abstracts or posters were presented at regional or national meetings from 21 projects across 11 divisions. Results from six projects were published in peer-reviewed manuscripts. Conclusions: Our QI curriculum offered fellows practical hands-on learning through sustainable QI projects aligned with their clinical practice, using PjBL as an instructional methodology integrated with the IHI Model for Improvement framework.