Medical schools are being challenged  to produce physicians who will work in teams with other healthcare professionals in a managed care delivery system.  Medical educators have called for future physicians to learn "new competencies" including interdisciplinary team skills, management and continuous quality improvement.

In 1996, Mayo Medical School implemented a new system for evaluation and integration for the Organ System Curriculum courses.  Our specific purpose was two-fold:  1) to teach continuous quality improvement principles to medical students, and 2) to provide an opportunity for students to apply those principles to evaluate how our medical school curriculum influenced their learning experience.

First and second year medical students were taught the essential principles of continuous quality improvement at the beginning of the organ system courses.  Focus groups of students and faculty identified eight activities (processes) which faculty engage in to deliver a medical school course.  Students and faculty designed a written survey instrument to evaluate how each of these eight processes influences student learning.  This survey instrument was administered at the end of each course and the results from the entire class were tabulated as the comprehensive evaluation.  The students were assigned to curriculum improvement teams before each course began.  Students were responsible for monitoring the learning activities as they occurred and for reviewing the comprehensive evaluation (all of the written surveys).  The students would meet and draft a one-page consensus evaluation that prioritized improvements that could enhance student learning.  The curriculum improvement team then met with the faculty and curriculum committee to discuss the evaluation.

Medical students were not enthusiastic about learning quality improvement principles in a didactic presentation, but they were very enthusiastic about applying quality improvement principles to curriculum evaluation.  The voluntary student response rate for course evaluations increased and the constructive quality of students' comments improved.  Faculty became more sensitive to student concerns and more responsive to student suggestions for improvements.  The curriculum committee thought that student/faculty communication improved and that committee time could be used more effectively to integrate the courses and identify opportunities for faculty development.  Students, faculty, curriculum committee, and administrative staff thought that significant curriculum improvement and integration occurred and that this curriculum evaluation process was more effective. 

In this IAMSE Audio Seminar, the Mayo Medical School experience was presented as a model and process by which students can learn quality improvement principles and apply these principles to curriculum evaluation and integration. Over a dozen medical schools in the United States have either adopted this system as presented, or modified it to their own unique needs.  Representatives from two such medical schools were present at this seminar.