Andrej Robida, MD, PhD, FACC
Andrej Robida MD, PhD, FACC

The current healthcare focuses on quality and safety, patient experience and staff satisfaction. Without proper education and training on these topics,  it will be impossible to achieve value for patients.


Where would  a good place to start with learning about continuous quality improvement (CQI) be? Where other than in schools, preparing young people for  future challenges of their profession. In recent years CQI and patient safety (PS) have had important implications for undergraduate and graduate medical and nursing  education in  economically advanced countries. However, in some  regions, including Slovenia, the notion, especially among physicians, is still to concentrate efforts on knowledge of medical and other healthcare sciences and  technical skills  ignoring the fact that healthcare is a sociotechnical system. A recent study in Slovenia showed that neither medical school  has a single hour of teaching dedicated to quality or patient safety.


There are examples of well-designed continuing medical education interventions that are sequenced and make use of interactive techniques, which lead to changes in learners’ behaviors and health outcomes. However, such studies are often centered on screening, smoking cessation, and communication skills and may not translate to more complex curricular content areas, such as QI and PS.


Readily available  good models of training exist that are sequenced and utilize interactive methods that lead  to  changes in students’ behavior and healthcare outcomes. Curricula for undergraduate students are based mainly on lectures, simulations,

story telling and  problem solving in small groups.


In the developed world CQI & PS  have achieved extensive recognition  as a central movement  for healthcare systems.  The curricula has been introduced in many schools, but not in every country. It would be wise for accreditation organizations to asses the competencies of healthcare professionals in these two domains. As far as medical, nursing schools and schools for other professionals are concerned the final exams should consider some emphasize in CQI & PS.


Existing literature shows  that educational curricula focused on QI and PS are well accepted by trainees, effectively improve knowledge in these domains, and can even lead to important improvements in processes of care.  In Slovenia there is only one nursing school that promotes the World Health Organization multi-professional curriculum taught at graduate level. There is not enough faculty with appropriate expertise  and not enough support for their development.


To succeed, these curricula require engagement of educational and organizational stakeholders to promote adoption. Future research must better characterize the learner, faculty, and institutional factors that facilitate or hinder the promotion of sustained educational efforts focused on QI and PS for medical students and postgraduate trainees.