Teaching and Assessing Resident Competence in Practice-based Learning and Improvement


  • Received from the Departments of Medicine and Community and Family Medicine (GO), Dartmouth Medical School, Hanover, NH; VA Medical Center (GO), White River Junction, Vt; Department of Medicine (LAH), School of Medicine, University of Missouri, Columbia, Mo; Department of Medicine (LAH, LJM), Center for Healthcare Research and Policy, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, Ohio; Department Medicine, Section of Geriatrics (LJM), Baylor College of Medicine, Houston, Tex; and Departments of Obstetrics and Gynecology and Community and Family Medicine (TF), Dartmouth-Hitchcock Medical Center, Lebanon, NH.

Address correspondence and requests for reprints to Dr. Ogrinc: White River Junction VA Hospital, 11Q, 215 North Main Street, White River Junction, VT 05009 (e-mail: greg.ogrinc@dartmouth.edu).


We designed, implemented, and evaluated a 4-week practice-based learning and improvement (PBLI) elective. Eleven internal medicine residents from 2 separate residency programs participated in the PBLI elective and 22 other residents comprised a comparison group. Residents in each group had similar pretest Quality Improvement Knowledge Application Tool scores; but after the PBLI elective, participant scores were significantly higher. Also, participants’ self-assessed ratings of PBLI skills increased after the rotation and remained elevated 6 months afterward. In this curriculum, residents completed a project to improve patient care and demonstrated their knowledge on an evaluation tool in a way that was superior to nonparticipants.