Experiential learning is essential to developing the ability to identify and institute sustainable systems-based changes to improve patient care. Residents must have the opportunity to participate in interprofessional quality improvement activities that include activities aimed at reducing healthcare disparities.

The ACGME requires that every resident participate in a formal quality improvement (QI) project at least once during their residency training. The critical elements of this expectation are as follows:

Participation: The resident has a well-defined and meaningful role in the project design, data collection, data analysis, and presentation of the results to other members of the department. Multiple residents should not occupy the same role in the project and simply observing or understanding the project is not a meaningful role.

Formal QI Project: A project in which data is evaluated before and after a QI intervention, to determine the effect of the intervention on system quality or patient safety.

• The project should be described in writing via the Quality Improvement Project PLAN form, with categories that identify its main elements, such as: title directors (the resident should be a director), purpose, rationale, methods, and endpoints for analysis.
• For most projects, it will be desirable to avoid words like “investigator” and “study” that are typically associated with research activities that require approval by an Internal Review Board (IRB).
• The scope and size of the project may be small and focused on a highly specific endpoint.
• The results of the project should be presented at a forum where the audience includes the other program residents and other members of the organization involved with the activity that is the subject of the project.

Timeline:

• PGY2 residents must submit a QI Project Plan by March 1.
• Projects must be completed by May of PGY4 year, including the presentation to department.
• Each resident should ask a faculty or staff member to be a mentor/advisor on their project.
• All projects must receive prior approval (before beginning) from the Residency Program Director.
• Detailed timeline updates should be sent quarterly to the Resident Program Coordinator.
• Project presentations need to be scheduled with the Residency Program Coordinator with at least a 1-2-month notice.
• Submit a copy of your concluding presentation to the department or other documentation that summarizes your project progress to the Residency Program Coordinator.

• Resident Didactics: Each resident will be expected to prepare one 60-minute seminar for presentation during each year of residency. The seminar is expected to be an in-depth presentation. The schedule and topic are arranged by the Residency Program Coordinator, Residency Program Director, and Chief Residents. The resident is responsible for obtaining a faculty mentor. The resident is required to notify the Residency Program Coordinator of the faculty mentor via email.
• Morbidity and Mortality (M&M): To ensure that all residents are educated about the possible short- and long-term consequences of radiation, M&M will be held once a month. M&M will not be scheduled during the month the American Society for Radiation Oncology (ASTRO) Annual Meeting is held. In addition, there is no M&M in December. Attending physicians will be responsible for presentation of the case, inclusive of all necessary supportive material. M&M informs participants of complication of radiation treatment, predictive factors of complications, and preventative strategies to reduce the severity and risk of complications. Specific conferences in the series also address end-of-life care and patient relations. Appropriate articles will be selected by the Chief Resident and approved by the faculty facilitator. Individual residents will select an approved article for presentation.
• Other Conferences: Other special clinical conferences will be arranged on a rotating basis, to broaden the breadth of resident education.

The residents are required to participate in educational sessions throughout the week. Therefore, every effort will be made not to interfere with educational activities during this protected time period. However, there are times when patient care needs will require that the resident be paged out of conference. These interruptions should be kept to a minimum. The following guidelines are intended to outline reasonable compromises between these two important responsibilities.