Quality Improvement Knowledge Application Tool - Revised

These are the current Quality Improvement Knowledge Application Tool – Revised (QIKAT-R) materials. There are 9 cases that have been used with resident physicians. Each case is scored on a 9-pt scale using the QIKAT-R scoring rubric. This rubric has been tested with teachers from around the world. It was published in Academic Medicine in October 2014 (Singh, Mamta K., et al. "The Quality Improvement Knowledge Application Tool Revised (QIKAT-R)." Academic Medicine 89.10 (2014): 1386-1391).

For each case, a subject is asked to write an aim, identify a measure, and recommend a change. The scoring system is a series of yes/no questions for each of the components for the cases: aim, measure, changes (see “case prompts” and “scoring rubric” files attached). We have found that 3-cases work best at a time (pretest and posttest).

The cases are complex, so there are many replies that would receive full credit. There is no official “passing” score and it has only been used as a pre-post assessment.

This is open access, public domain materials, but please cite us as you use it. If you write new cases or modify the current ones, please send them to us at squire@squire-statement.org so that we can share them with others on the website

Thanks so much for your interest and use of the QIKAT-R!

Mimi Singh, MD, MS
Greg Ogrinc, MD, MS
Karen Cox, RN, PhD
Mary Dolansky, RN, PhD
Julie Brandt, PhD
Laura J. Morrison, MD
Beth Harwood, Med
Greg Petroski, PhD
Al West, PhD
Linda A. Headrick, MD, MS


QIKAT-R Citations

Jones, Anne C., Scott A. Shipman, and Greg Ogrinc. "Key characteristics of successful quality improvement curricula in physician education: a realist review." BMJ quality & safety 24.1 (2015): 77-88.

Fok, Mark C., and Roger Y. Wong. "Impact of a competency based curriculum on quality improvement among internal medicine residents." BMC medical education 14.1 (2014): 1.

Rinke, Michael L., et al. "The Armstrong Institute Resident/Fellow Scholars A Multispecialty Curriculum to Train Future Leaders in Patient Safety and Quality Improvement." American Journal of Medical Quality (2015): 1062860614568523.

Bowe, Sarah N., et al. "Programmatic Assessment of a Comprehensive Quality Improvement Curriculum in an Otolaryngology Residency." Otolaryngology--Head and Neck Surgery (2016): 0194599816654685.

Wong, Brian M. "Reporting on Patient Safety and Quality Improvement Education: Designing Projects for Optimal Dissemination." Journal of graduate medical education 7.4 (2015): 513-516.

Tentler, Aleksey, et al. "Integrating a Resident-Driven Longitudinal Quality Improvement Curriculum Within an Ambulatory Block Schedule." Journal of Graduate Medical Education (2016).

Kadom, Nadja, et al. "Radiology Residency Quality Improvement Curriculum: Lessons Learned." Current problems in diagnostic radiology (2016).

A. McNamara, Deborah A., Paul Rafferty, and Fidelma Fitzpatrick. "An improvement model to optimise hospital interdisciplinary learning." International journal of health care quality assurance 29.5 (2016).

QIKAT-R Materials

QIKAT-R Case Prompts

QIKAT-R Scoring Rubric

Scenario 1 - Inpatient Medicine

Scenario 2 - Emergency Department

Scenario 3 - Primary Care

Scenario 4 - Diabetes

Scenario 5 - Admissions

Scenario 6 - Orthopedic Surgery

Scenario 7 - Nephrology

Scenario 8 - Anesthesia

Scenario 9 - Radiology