From Pieces to Processes: Teaching Health Care Process Optimization and Quality Improvement Through a Building Brick Simulation.

INTRODUCTION: Teaching quality improvement in medical education is challenging due to limited experiential learning. To address this, we implemented a patient care simulation utilizing building bricks to teach process mapping, root cause analysis, and iterative change. METHODS: Second-year medical students (N = 480) participated in a 2-hour session simulating emergency department patient flow. Teams of 7-8 students assumed roles within the hospital, simulating steps in patient encounters, identifying problems, and testing iterative changes. Pre- and posttest assessments measured quality improvement knowledge and interprofessional competencies. Data collected from groups completing the simulation and annual postactivity reflections over 3 years were analyzed for themes. RESULTS: Session quality ratings were significantly higher than other clinical-year health systems sessions in 2025 (4.23 vs 3.50), 2024 (4.15 vs 3.40), and 2023 (4.08 vs 3.51) on a 5-point Likert scale. In 2025, knowledge scores increased from 75.7% (SD = 1.13) pretest to 87.3% (SD = 0.894) posttest (P < .0002). By objective, gains were greatest for applying the scientific method to quality improvement, recognizing multiple root causes, and testing 1 countermeasure at a time (P < .001). Simulation data demonstrated sustained improvement in patient throughput. DISCUSSION: This simulation engaged medical students and improved their understanding of health care systems, process optimization, and interprofessional teamwork. By engaging in root cause analysis and iterative improvement, students demonstrated enhanced competencies in quality improvement principles. Future iterations will refine the model and explore its application across additional clinical contexts.