Internal medicine residency graduates' perceptions of the systems-based practice and practice-based learning and improvement competencies

Background: Resident education in Systems-Based Practice (SBP) and Practice-Based Learning and Improvement (PBLI)is required but under emphasized. Purposes: The objectives are to identify SBP and PBLI knowledge and skills with the most relevance to our graduates' practices and to determine how well they were prepared during residency training to address these issues. Methods: A survey was drafted based on Accreditation Council for Graduate Medical Education competency definitions and published literature on SBP and PBLI. Respondents indicated the extent to which each item is relevant to their practice and the adequacy of instruction received on a 5-point Likert scale. Results: All topics had high perceived relevance to practice with most topics rated low for adequacy of training. Topics of practice management and health care economics contained the largest gaps between mean ratings of relevance and adequacy of training (p<.001). Few differences in ratings were seen based on graduate demographics. Conclusions: This survey has allowed us to prioritize SBP and PBLI curricula to meet the needs of our graduates.