Integration of medical students within improvement teams to optimise practice based improvement education

Mechanisms of Improvement

Medical Students as Agents of Change: A qualitative exploratory study of student and staff experiences

What we know

Students have the potential to contribute actively to quality improvement (QI) in healthcare by initiating, leading and bringing about change within organisations. Although a growing body of literature advocates the importance of embedding QI throughout undergraduate medical programmes, there is currently little understanding about the best educational methods for achieving this. In contrast to traditional teaching styles, where QI is introduced in the standard classroom curriculum, there is growing interest in whether immersing students in QI projects within real-world health settings can help to foster individual learning and wider organisational change.

Research Aim

The aim of this study was to explore the perspectives and experiences of medical students and their mentors after undertaking quality improvement projects within the healthcare setting, and if such practice-based experiences were an effective way of building improvement capacity and changing practice.

What this research explored

A qualitative interpretive description methodology, using focus groups with medical students and semi-structured interviews with academic and clinical mentors following completion of students’ 4-week quality improvement projects was adopted.

What this study adds

The findings indicate that there are a range of facilitators and barriers to undertaking and completing quality improvement projects in the clinical setting, such as time-scales, differing perspectives, roles and responsibilities between students and multidisciplinary healthcare professionals. This study demonstrated that quality improvement experiential learning can develop knowledge and skills among medical students and transform attitudes towards quality improvement. Furthermore, it can also have a positive impact on clinical staff and healthcare organisations. Despite inherent challenges, undertaking quality improvement projects in clinical practice enhances knowledge, understanding and skills, and allows medical students to see themselves as important influencers of change as future doctors.


This project was led by the SISCC team based at the School of Health Sciences, in conjunction with colleagues from the School of Medicine at the University of Dundee and staff and students within NHS Tayside.


Burnett E, Davey P, Gray N, et al. Medical students as agents of change: a qualitative exploratory study. BMJ Open Quality 2018;7:e000420. doi: 10.1136/bmjoq-2018-000420

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