Medical interns’ experiences of conducting quality improvement projects during a family medicine rotation in primary healthcare settings in South Africa: a qualitative study

Quality improvement (QI) is increasingly incorporated into medical education and postgraduate training internationally, providing trainees with practical experience in improving healthcare delivery. In South Africa, the Health Professions Council of South Africa requires second-year medical interns to complete a quality improvement project (QIP) during their Family Medicine rotation. However, little is known about interns’ experiences of conducting these projects in primary healthcare settings. An exploratory qualitative study involved 18 purposively selected participants. We conducted semi-structured interviews lasting 30–45 min virtually via Zoom or Microsoft Teams between November 2024 and August 2025. We audio-recorded and transcribed interviews verbatim until we reached data sufficiency. Thematic analysis was achieved using ATLAS.ti software. Participants’ mean age was 28.6 years; most were female (88.9%, n = 16), and 83.3% ( n = 15) had undergraduate training in South Africa. Five themes emerged: the first four highlighted strengths, and the fifth addressed challenges in QIP implementation. Strengths included involvement in team-based collaboration, enhanced patient engagement, a supportive learning environment and strengthened data literacy. Challenges included inadequate knowledge and competing clinical demands. Participation in QIPs gave interns opportunities to develop teamwork, communication, and data literacy skills while engaging in quality improvement in clinical practice. Structured training, protected time, mentorship and supportive supervision may strengthen interns’ engagement with QIPs.