Improvement Cycles in Medical Education: From Quality Improvement to Patient Care and Clinical Research

Improvement cycles are regularly used by performance improvement teams to optimize patients’ outcomes by improving the quality of care. One of the best-known cycles for performance improvement in healthcare is the Plan-Do-Study-Act (PDSA) cycle (Figure 1a).[1] During the first phase, Plan, we identify barriers to optimal care, develop a plan to implement new interventions, and identify the outcomes that will be monitored; during the second phase, Do, the new interventions are implemented; during the third phase, Study, we measure the outcomes defined in the planning phase to assess improvement; and during the fourth phase, Act, we make changes to our practice before beginning the next iteration of the cycle to improve implementation.