Evidence map›Paper›PMID 33897957›Full record

ArticleJournal of graduate medical education2021

Comparing the Effects of Design Thinking and A3 Problem-Solving on Resident Attitudes Toward Systems Change.

Ryan Buckley, Anthony Spadaro, Roy Rosin, Judy A Shea, Jennifer S Myers

Abstract read
In one paragraph

Article in Journal of graduate medical education, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Change Management and Innovation in Graduate Medical Education.Journal of graduate medical education · 2025
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ryan BuckleyAt the time of research, was a Faculty Member, Perelman School of Medicine at the University of Pennsylvania, and is now Assistant Professor of Clinical Medicine, Section of Hospital Medicine, Division of General Internal Medicine & Public Health, Department of Medicine, Vanderbilt University Medical Center.
Anthony Spadarois a Resident Physician, Department of Emergency Medicine, Perelman School of Medicine, University of Pennsylvania.
Roy Rosinis Chief Innovation Officer, Penn Medicine, University of Pennsylvania.
Judy A Sheais Professor of Medicine, Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania.
Jennifer S Myersis Professor of Clinical Medicine, Section of Hospital Medicine, Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundQuality improvement (QI) is a required component of graduate medical education. Many medical educators struggle to foster an improvement mindset within residents.

objectiveWe conducted a mixed-methods study to compare a Design Thinking (DT) approach to QI education with a Lean, A3 problem-solving approach. We hypothesized that a DT approach would better promote a mentality of continuous improvement, measured by residents' resistance to change.

methodsThirty-eight postgraduate year 2 internal medicine residents were divided into 4 cohorts during the 2017-2018 academic year. One cohort participated in an experimental QI curriculum utilizing DT while 3 control cohorts participated in the existing curriculum based on Lean principles. Participants voluntarily completed a quantitative Resistance to Change (RTC) scale pre- and post-curriculum. To inform our understanding of these results, we also conducted semistructured interviews for qualitative thematic analysis.

resultsThe effect size on the overall RTC score (response rate 92%) was trivial in both groups. Three major themes emerged from the qualitative data: factors influencing the QI learning experience, factors influencing creativity, and general attitudes toward QI. Each contained several subthemes with minimal qualitative differences between groups.

conclusionsThis study found similar results in terms of their effect on attitudes toward systems change, ability to promote creative change agency, and educational experience. Despite positive educational experiences, many residents still did not view systems-based problem-solving as part of their professional identity.

Indexed as

Internship and ResidencyAttitudeCurriculumEducation, Medical, GraduateHumansQuality Improvement

Identifiers

PMID33897957
PMCPMC8054598

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.