National implementation of a pragmatic quality improvement skills curriculum for urology residents in the UK: Application and results of ‘theory-of-change’ methodology

Zuhur Balayah, Zarnie Khadjesari, Aoife Keohane, Wilson To, James S. A. Green, Nick Sevdalis

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
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Background: There is global momentum to establish scalable Quality Improvement (QI) skills training curricula. We report development of an implementation plan for national scale-up of the ‘Education in Quality Improvement’ program (EQUIP) in UK urology residencies. Materials & methods: Theory-of-Change (ToC) methodology was used, which engaged EQUIP stakeholders in developing a single-page implementation ‘Logic Model’ in 4 study phases (2 stakeholder workshops (N = 20); 10 stakeholder interviews). The framework method was used for analysis. Results: Core elements of the EQUIP Logic Model include: (i) QI curriculum integration into national surgical curricula; (ii) resident-led, modular, team-based QI projects; (iii) development of a national web-platform as QI projects library; (iv) a train-the-trainers module to develop attendings as QI mentors; and (v) knowledge transfer activities (e.g., peer-reviewed publications of residents’ QI projects). Conclusions: ToC methodology was useful in developing a stakeholder-driven, actionable implementation plan for the national scale-up of EQUIP in the UK.
Original languageEnglish
Pages (from-to)401-409
Number of pages9
JournalThe American Journal of Surgery
Issue number2
Early online date3 Dec 2020
Publication statusPublished - Feb 2021

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