Jenithaa Muthu, Krupa Venkatraman, Latika Ganesh
Comparative analysis of story-grammar development: a cross-sectional study of Tamil-speaking child cochlear implant users and hearing peers in Tamil Nadu, India
BMJ open
increasing emphasis resident involvement quality improvement qi efforts yet resident engagement qi remained low many reasons although qi methods classically applied clinical processes many opportunities incorporate qi principles curricular design implementation demonstrate utility qi methods applied curricular design implementation novel pointofcare ultrasound portfolio development quality assurance program large internal medicine residency program applied foundational qi methods including process mapping plandostudyact pdsa cycles timetrap identification runchart analysis qualitative interviews throughout curricular design implementation phases rapidly identify areas improvement perform timely tests change fiftyone interns participated curriculum submitting 731 images first trimester process mapping submission review revealed 29 images saved incorrect digital archive residentreviewer interpretation concordance present 807 submissions 952 completed quality assurance cards information provided commentary feedback evaluators checklists representing time trap interventions included restricting access image archives removing redundant fields quality assurance cards time feedback fell 695 65 days demonstrating nonrandom variation via runchart analysis pilot study demonstrates successful application qi methods novel pointofcare ultrasound curriculum systematic use methodologies curricular design implementation allows expeditious curricular improvement emphasizing relevance qi methods subject matter beyond clinical processes may increase resident engagement qi efforts