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Use of spaced education to deliver a curriculum in quality, safety and value for postgraduate medical trainees: trainee satisfaction and knowledge
  1. Jeffrey Bruckel1,
  2. Victoria Carballo2,
  3. Orinta Kalibatas2,
  4. Michael Soule3,
  5. Kathryn E Wynne4,
  6. Megan P Ryan5,
  7. Tim Shaw6,
  8. John Patrick T Co4,7
  1. 1Edward Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Quality, Safety, and Value Division, Partners HealthCare, Boston, Massachusetts, USA
  3. 3Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
  4. 4Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts, USA
  5. 5Central Coast Local Health District, University of Sydney, Sydney, Australia
  6. 6Workforce Education and Development Group, University of Sydney, Sydney, Australia
  7. 7Graduate Medical Education, Partners HealthCare, Boston, Massachusetts, USA
  1. Correspondence to Dr John Patrick T Co, Partners HealthCare, Director of Graduate Medical Education, 7 Whittier Place, Suite 108, Boston, MA 02114, USA; jco{at}


Purpose Quality, patient safety and value are important topics for graduate medical education (GME). Spaced education delivers case-based content in a structured longitudinal experience. Use of spaced education to deliver quality and safety education in GME at an institutional level has not been previously evaluated.

Objectives To implement a spaced education course in quality, safety and value; to assess learner satisfaction; and to describe trainee knowledge in these areas.

Methods We developed a case-based spaced education course addressing learning objectives related to quality, safety and value. This course was offered to residents and fellows about two-thirds into the academic year (March 2014) and new trainees during orientation (June 2014). We assessed learner satisfaction by reviewing the course completion rate and a postcourse survey, and trainee knowledge by the per cent of correct responses.

Results The course was offered to 1950 trainees. A total of 305 (15.6%) enrolled in the course; 265/305 (86.9%) answered at least one question, and 106/305 (34.8%) completed the course. Fewer participants completed the March programme compared with the orientation programme (42/177 (23.7%) vs 64/128 (50.0%), p<0.001). Completion rates differed by specialty, 80/199 (40.2%) in non-surgical specialties compared with 16/106 (24.5%) in surgical specialties (p=0.008). The proportion of questions answered correctly on the first attempt was 53.2% (95% CI 49.4% to 56.9%). Satisfaction among those completing the programme was high.

Conclusions Spaced education can help deliver and assess learners’ understanding of quality, safety and value principles. Offering a voluntary course may result in low completion. Learners were satisfied with their experience and were introduced to new concepts.


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