Quality Improvement (QI) knowledge and skills are required at all levels of physician training. System improvement efforts need to include understanding of health disparities and design of interventions to reduce those disparities, thus health equity needs to be integrated into QI education. Payors, accreditation bodies and health systems’ emphases on QI result in the need for QI curricula that meet the needs of diverse learners. This article presents a theoretical background and practical tools for designing, implementing, and evaluating a QI educational program across the spectrum of physician training with an emphasis on competency-based education and a goal of continuous practice improvement. Practice-based learning and improvement and systems-based practice are two core domains of competencies for readiness to practice. These competencies can be met through the health systems science framework for studying improvement in patient care and health care delivery coupled with QI science. Curricula should incorporate interactive learning of theory and principles of QI as well as mentored, experiential QI project work with multidisciplinary teams. QI projects often develop ideas and implement changes but are often inconsistent in studying intervention impacts or reaching the level of patient outcomes. Curriculum design should incorporate adult learning principles, competency based medical education, environmental and audience factors, and formats for content delivery. Key QI topics and how they fit into the clinical environment and teaching resources are provided, as well as options for faculty development. Approaches to evaluation are presented, along with tools for assessing learner's beliefs and attitudes, knowledge and application of QI principles, project evaluation, competency and curriculum evaluation. If the goal is to empower the next generation of change agents, there remains a need for development of scientific methodology and scholarly work, as well as faculty development and support by institutions.

各级医师培训都需要质量改进（QI）知识和技能。系统改进工作需要包括了解健康差异和设计干预措施以减少这些差异，因此健康公平需要纳入质量教育。付款人、认证机构和卫生系统对 QI 的重视导致需要满足不同学习者需求的 QI 课程。本文介绍了设计、实施和评估整个医师培训范围内的 QI 教育计划的理论背景和实用工具，重点是基于能力的教育和持续实践改进的目标。基于实践的学习和改进以及基于系统的实践是实践准备能力的两个核心领域。这些能力可以通过卫生系统科学框架来实现，该框架用于研究患者护理和卫生保健服务的改进以及质量科学。课程应纳入 QI 理论和原理的互动学习，以及与多学科团队进行指导、体验式 QI 项目工作。QI 项目经常提出想法并实施变革，但在研究干预影响或达到患者结果水平方面往往不一致。课程设计应纳入成人学习原则、基于能力的医学教育、环境和受众因素以及内容交付格式。提供了关键的 QI 主题以及它们如何适应临床环境和教学资源，以及教师发展的选择。介绍了评估方法以及评估学习者信念和态度、QI 原则知识和应用、项目评估、能力和课程评估的工具。如果目标是赋予下一代变革推动者权力，则仍然需要发展科学方法和学术工作，以及师资发展和机构支持。