There is no standard curriculum or metric for evaluating success of family residency quality improvement (QI) projects. A survey of 321 U.S. family medicine residency program directors asked how programs teach QI and who supervises projects. The survey also asked whether residents can get to clinic data, how projects are organized, and what the projects achieve. They found:
Most programs used a hybrid curriculum combining their own materials with outside resources (46.8%) or a curriculum they built themselves (38.8%).
More than one-quarter of programs (26.6%) said residents faced significant barriers getting the clinic data their projects required.
Graduates were rated as more skilled in programs using a hybrid curriculum, where core faculty supervised projects, residents had better data access, projects were handed down from one resident class to the next, and results were shared beyond the program.
The three project factors linked to tangible clinical change were having residents working in teams rather than alone, projects continuing across resident classes, and results being presented or published.
Why It Matters: The findings suggest that a successful residency quality improvement education results from a system built on a formal curriculum, accessible data infrastructure, and projects designed to outlast a single resident’s experience.
Quality Improvement in Residency: Training, Projects, and Outcomes
Corresponding Author: Lauren E. Harriet, DO, MBA, et al
Department of Family Medicine, University of Chicago, Chicago, Illinois
The Annals of Family Medicine
21-Sep-2026