Brief outline of context: The improvement project was done within an Occupational therapy department in an orthopaedic clinic. People involved : Occupational therapy students, University lecturer, Head of Occupational therapy department and supervisors.
Brief outline of problem: Since 2004 the Occupational therapy students perform a personal improvement work. The aim is to facilitate the learning of knowledge of improvement and in the long run make it possible to be used in the professional work. But the problem is how we should make it possible for the students to transfer knowledge and skills of personal improvement to professional work?
Assessment of problem and analysis of its causes: A local evaluation of a national project for implementing Knowledge of improvement in Swedish Universities showed that students’ knowledge could not be obvious until they are a part of a team within healthcare.
The head of the occupational therapy department in the orthopaedic clinic criticized how students’ fieldwork assignments were organised. She suggested students to be a part of the clinics quality improvement. To try this out we involved two students within a 5 weeks fieldwork course (autumn 2006).
Strategy for change: 6 students who did a fieldwork course in the orthopaedic clinic was asked to participate in this project (intervention group). Instead of doing a separate theoretical assignment these students was a part of the clinics improvement work and created Occupational therapy Guiding principles for specific patient groups. 6 other students in the same course participated as a control group.
The supervisors in the intervention group were informed and prepared. The project was implemented spring and autumn 2007 and was evaluated spring 2008.
The results of the project has been documented and presented in a seminar for staff in charge of Futurum, the Academy for Health and Care and Head of the Department of Rehabilitation, School of Health Sciences and other lecturers in the university.
Measurement of improvement: Both intervention group and control group did a self assessment of fulfilment based on course aims in a 6 graded scale. In addition the intervention group did a self assessment of fulfilment based on “8 Knowledge domains for health care students seeking competency in continual improvement an innovation of health care“ inspired by Institute for Healthcare Improvement, Boston, in a 6 graded scale. The self assessment was done before and after the field work.
Effects of changes: The control group fulfilled the course aims in a higher extent than the intervention group. A possible cause can be that the intervention group put higher effort and energy in the assignment so they missed to fulfil the course aims to a sufficient high level.
The intervention group assessed higher knowledge after than before in all of the “8 knowledge of domains” although they had difficulties to understand the meaning of the concepts
Lessons learnt: To go from a personal improvement work to a professional is too difficult. In the Program we have started to create a stripe with knowledge of improvement through the education. There will be an element in every semester and the content shall be progressive. The “8 Knowledge domains” follow the stripe and are adjusted to fit course aims. In the end of the education the students summarize and evaluate their knowledge of improvement and have an idea of how to continue their learning.
Message for others: The complexity of today’s health care increase and this put greater demands on educations to prepare our students to be “Improvers”. The knowledge of improvement must be a natural element in health care education BUT it must be progressive an adjusted to the specific education