Bibliographic record
Abstract
CONTEXT: Medical schools face growing pressures to develop quality improvement (QI) strategies to ensure the continuous quality of their education. To best achieve quality, both organisational processes and culture need to be oriented towards quality. Quality processes already exist at medical schools, at least externally driven by accreditation. However, the dominant culture in most medical schools is not typically oriented towards quality. OBJECTIVES: This study explores whether QI practices are recognised as such in organisations not culturally QI-oriented. Specifically, it examines faculty members' perceptions about the degree of QI implementation in their medical education programmes. Understanding this perception will inform medical school leadership on how best to use resources for a successful execution of the school's QI vision. METHODS: Leaders, clinical teachers and formal teachers at 16 of the 17 Canadian medical schools were invited to complete the 'Are We Making Progress?' questionnaire of the Malcolm Baldrige National Quality Award framework, the results of which have been broadly validated. The questionnaire measures the perceived level of QI implementation within organisations using 40 statements grouped under the framework's seven domains of performance excellence. RESULTS: A total of 491 respondents from 11 (69%) schools completed the questionnaire; 173 (35%) identified as clinical teachers, 150 (31%) as formal teachers, and 168 (34%) as leaders. Perceived QI implementation levels were low across programmes (0.70-1.90 in Rasch person measures) and for each category of respondents. This was especially true for the domains of 'Strategy', 'Measurement/analysis/knowledge management' and 'Operations'. Leaders' perceptions of QI implementation were higher than those of teachers. CONCLUSIONS: Medical schools' existing QI processes are not recognised as QI activities. For QI strategies to succeed, a programme's culture must embrace QI. In the execution of their QI visions, medical schools should spend resources on embedding quality in the organisation culture in addition to strengthening existing QI practices, especially in the domains listed above.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.009 | 0.019 |
| Scholarly communication | 0.012 | 0.004 |
| Open science | 0.001 | 0.008 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".