Health disparities learning in a Project-Based Quality Improvement Curriculum

Abstract Background Health disparities remain a persistent challenge in medicine, exacerbated by inequitable practices within healthcare systems and among professionals. Quality improvement (QI) methods are well-suited for discovering and addressing disparities, and many medical school curricula incorporate QI. However, most of these curricula do not highlight the applicability of QI to health disparities as a primary learning objective. This study explores medical students’ learning about disparities through a project-based QI curriculum and facilitators and inhibitors of learning through this approach. Methods We conducted an exploratory constructivist qualitative study in which we interviewed 11 medical students who completed a 15-month QI curriculum during their pre-clerkship years. We analyzed interview transcripts using conventional qualitative content analysis. Results Students described how their experiences in a project-based QI curriculum, contributed to their knowledge of evidence related to disparities, provided a nuanced understanding of patient experiences, gave them an actionable framework for addressing disparities, and motivated them to apply these skills. Based on students’ descriptions of their experiences, we identified factors such as project setting, patient experiences, faculty mentorship, and student goals that shaped students’ learning about disparities through a project-based QI curriculum. Conclusions A project-based QI curriculum can provide students with opportunities to engage with health disparities and develop skills to identify, understand, and address health disparities throughout their training and into their careers. However, careful attention must be given to students’ experiences when this approach is used to facilitate learning about health disparities. Our findings suggest that designing the curriculum with specific learning objectives related to disparities, providing faculty development, and careful project selection are important ways that curricular leaders can optimize a project-based QI curriculum for disparities-related learning.