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QIPS Competencies

Quality Improvement & Patient Safety Competencies

Background and Context

While education in quality improvement (QI) and patient safety (PS) is now being endorsed at all levels of medical education and professional training, the specific knowledge, skills, and attitudes necessary for students and residents to gain competence in the disciplines of QIPS have not been formally agreed upon or published by national medical education bodies. Further, in areas where some of these competencies have been articulated (e.g. ACGME milestones), there is not yet consistency across medical specialties. This is problematic for several reasons: 

  • The lack of consensus for QIPS competencies presents a barrier to medical education nationally since the educational objectives are  neither clear nor consistent;

  • The assessment of QIPS competencies are beginning to be incorporated into national accreditation and board certification examinations by the National Board of Medical Examiners (NBME) and the American Board of Medical Specialties (ABMS). Without a clear outline of competencies, medical schools and graduate medical education training programs will have difficulty preparing their trainees for success on these examinations;

  • There are few faculty experts in QIPS, and having different QIPS milestones (i.e. competencies) in different medical specialties makes it challenging for GME educators to develop and employ shared curricula and assessment tools; and

  • As more advanced training programs in QIPS develop nationally, articulating the core competencies for graduating medical students and residents will be necessary to differentiate novice from competent to proficient to expert. 

These realities have led to confusion and uncertainty for medical schools, residency/fellowship programs, and medical educators who are looking for guidance. Recent efforts to move the field of QIPS in medical education forward include AAMC's Teaching for Quality Report, and the ACGME Milestones Project, among others. While each of these efforts is excellent, none has specifically attempted to obtain consensus on the competencies in QIPS. Indeed, the AAMC Teaching for Quality Report writing group articulated the need to identify the competencies for QIPS more discretely.

AAMC believes there is critical need to engage influential stakeholder organizations in medical education and QIPS as well as respected leaders in the field of health care QIPS to agree upon the core competencies in QIPS, garner broad consensus, and disseminate the competencies to U.S. medical schools and residency programs. Given AAMC’s mission to serve and lead the academic community to improve the health of all, AAMC is poised to lead this national effort.

Project Overview & Goal

AAMC has held focused discussions to gather perspectives from a diverse group of constituents about the role AAMC might have in advancing competencies in QIPS during the 2016 and 2017 AAMC Integrating Quality Meetings. The need for the development of QIPS competencies to inform education and practice across the continuum was supported by the participants.

Building from and informed by previous efforts (i.e., AAMC, ACGME), in 2017 and 2018 AAMC is convening a diverse workgroup to develop competencies for QIPS that seeks broad stakeholder feedback from national experts in the field and garners meaningful consensus toward their ultimate use in the field. View a list of working group members. 

The goal of the project is to create consensus around a set of tiered competencies for QIPS that will be aligned with the common competencies first adopted in 1999 by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). These competencies will be tiered according to practice level and will include developmental progression within each of three levels (student – resident/fellow – faculty/leader).These measurable competencies are intended to serve as a roadmap for curricular and professional development, performance assessment, and improvement of health care services and outcomes. 

Stakeholder Engagement

Over the course of 18 months, the AAMC has engaged hundreds of stakeholders in numerous focus groups and a survey method (modified Delphi) to gather input from the broad medical education (UME, GME, CME), patient care, and quality and patient safety communities. This feedback has led to the drafting of competencies representing five domains of patient safety and quality improvement. The third draft will be shared during a concurrent session to be held at the AAMC Learn Serve Lead meeting on November 4, 2018 in Austin, Texas. We anticipate publishing the AAMC QIPS Competencies v1.0 in early 2019. To view the current DRAFT of the QIPS competencies, click here .

Feedback or Questions

Please direct any questions or comments on the QIPS Competencies Project to AAMC at

Last Updated: October 2018