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Portland Campus · School of Nursing

Exemplar - Improvement Science

  • Summer 2021
  • 3 Credits
  • 06/28/2021 to 09/10/2021
  • Modified 07/19/2022


This course is the third in a series to prepare students to deliver patient-centered care that emphasizes evidence-based practice (EBP) and quality improvement (QI) focusing on improvement science (IS) methodologies. The purpose of this course is to utilize improvement science to eliminate discrepancies between identified standards of care and clinical practice. Students will build core competencies in improvement science, including appraising the IS literature, differentiating IS methodologies, testing and measuring change, displaying findings and participating in continuous improvement activities.

Contact Information

Course Lead: Dr. Doria K Thiele, PhD, CNM, IBCLC

Meeting Times

Course Delivery Mode

This course is conducted fully online in an asynchronous model. Students are expected to log into the site regularly, at least three times per week, in order to meet course requirements. Students are also expected to check their OHSU email accounts for notifications. Assignments are posted and submitted through the Sakai course site.


Required Texts and Readings

Langley, G. J., Moen, R. D., Nolan, K. M., Nolan, T. W., Norman, C. L., & Provost, L. P. (2009) The improvement guide: A practical guide to enhancing organizational performance (2nd ed.). San Francisco. Jossey-Bass. ISBN-13: 978-0470192412; ISBN-10: 0470192410

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). Washington, DC: Author.

Supplemental Suggested Readings or Reference Material

The Institute for Healthcare Improvement (IHI) Open School Courses available at , and outlined in the Sakai course materials

Course Competencies, Outcomes, and Objectives

Upon successful completion of this course, the student will be able to:

  1. Demonstrate foundational knowledge of improvement science theories and methodology.
  2. Distinguish between improvement science, research and implementation science.
  3. Differentiate the phases of the improvement process, evaluation, and tools for sustainability.
  4. Utilize measures, data collection procedures, analysis, data displays for improvement science projects.
  5. Understand the application of improvement models in practice.
  6. Design, implement and evaluate an improvement science project.



Course Outcome

Assignment/activity to meet outcome (note graded or not)

Related DNP Program  Outcome

1. Demonstrate foundational knowledge of improvement science theories and methodology.



IHI modules

Assignments (70%)

Quizzes (30%)

1, 2, 4, 6

2. Distinguish between improvement science, research and implementation science.



IHI modules

Assignments (70%)

Quizzes (30%)

1, 4, 5, 6

3. Differentiate the phases of the improvement process, evaluation, and tools for sustainability.



IHI modules

Assignments (70%)

4, 5, 6

4. Utilize measures, data collection procedures, analysis, data displays for improvement science projects.



IHI modules

Assignments (70%)

4, 5, 6

5. Understand the application of improvement models in practice.



IHI modules

Assignments (70%)

4, 5, 6

6. Design, implement and evaluate an improvement science project.



IHI modules

Assignments (70%)

Quizzes (30%)

4, 5, 6

DNP Program Outcomes

  1. Demonstrate readiness to enter clinical practice via specialty competencies with the appropriate scientific knowledge, and considerations for its application to practice.
  2. Apply ethical principles along with the standards of professional conduct to clinical care, research, and education.
  3. Evaluate emerging healthcare systems and policy that influence delivery of cost effective patient care.
  4. Generate entry level practice scholarship through completion of a clinical practice improvement project based on the principles of improvement science.
  5. Model interprofessional communication and collaboration to improve individual and/or population health outcomes.
  6. Identify and address gaps in professional knowledge though ongoing reflection to support the principle of life-long learning.

Course & Instructor Evaluations

Course evaluations are used to  improve and refine course content, delivery, and effectiveness. Your feedback is critical to improving this course. As your faculty, we want to know what works well, what didn't work so well, and constructive suggestions for improving.

At the end of the term all students will be asked to complete the course and faculty evaluations. Providing evaluation and constructive feedback is part of professional conduct. The time you take to respond will be greatly appreciated because your feedback will be critical to the improvement process. 





Introduction to Improvement Science: Frameworks, models, theories

Improvement Science, Research, and Implementation Science


Application of an Improvement Model I: Identify the clinical problem, Evaluate the literature


Application of an Improvement Model II: Develop an aim statement, Root cause analysis


Application of an Improvement Model III: Rationale and Context


Methods of Improvement Science I: Measures and outcomes


Methods of Improvement Science II: Proposed intervention, PDSA cycle


Methods of Improvement Science IV: Data analysis and display


Dissemination of Improvement Science I: Results and Conclusions


Dissemination of Improvement Science II: Sustainability and Scaling


Course Evaluation

Course Policies and Resources

In this 3-credit online course, students are expected to participate in all course activities (readings, discussion, etc.) a minimum of 15 hours per week. Students are expected to log into the site regularly, at least three times per week, in order to meet course requirements. Attendance will be partially monitored through student’s active participation and involvement in the Sakai online course site. Students are also expected to check their OHSU email accounts for notifications and faculty communications.

This course relies on students demonstrating professional behavior in all group work.  Group work is essential to learning the dynamics of improvement science.  Students are expected to communicate effectively with group colleagues, be timely in all assignments, and provide their best work to team efforts.  Any student determined to be behaving unprofessionally with group work will be removed from their group and will complete all remaining assignments on their own.

All assignments are to be submitted as indicated in the course materials. If a student cannot meet the due date/time for some reason, they need to contact faculty before the due date to make other arrangements. In case of emergency (student not able to contact faculty before the due date/time) contact faculty as soon as possible. Unforeseen emergencies will be considered on a case-by-case basis. 

Final Grade Rounding Policy

Final Grades will not be rounded.

School Policies and Resources

Grading Criteria, Academic Standards, and Release of Final Grades

School of Nursing final course grades will be posted with the OHSU registrar the Monday following the last day of the term. The School of Nursing grading system for official grade reports includes:

Letter & Grades Numerals used by Registrar for GPA Percentage



93 - 100



90 - 92



87- 89



83 - 86



80 - 82



77 - 79



73 - 76



70 - 72



0 - 69

In the School of Nursing, in the graduate programs a grade of less than a C (2.0) is failing and in the undergraduate programs a grade of less than C- (1.7) is failing. Additionally, please see OHSU policy, 02-70-035 Degree/Certificate Standards for additional information on cumulative OHSU GPA requirements for graduation.

Refer to the SON admission, progression, probation, and dismissal standards for withdraw, incomplete, and in progress grading standards. See School of Nursing policy website for a complete list of policies.

Please note: OHSU policy requires Sakai sites to close three weeks after grades have been submitted to the registrar in compliance with us copyright law and adherence to the fair use doctrine of copyrighted materials in educational settings.  You have the right to retain a copy of any downloadable material posted to an online class.  You are encouraged to download any needed material before sites are permanently closed.


All graded examinations must be either proctored or fully open resource, OHSU Policy 02-70-050, Exam Proctoring. 


Proctored Exam:  An exam that is overseen by an impartial individual (called a proctor) who monitors or supervises a student while he or she is taking an exam. The proctor ensures the security and integrity of the exam process, OHSU policy 02-70-050.  In the SON, students should assume that resources are not to be used during proctored exams, unless specifically stated by the faculty member before the exam is given.

Non-Proctored Assessments:  Not all assessments of student work require proctors. Graded assignments, take home exams, open book exams, or term papers may be completed by students without a proctor, OHSU policy, 02-70-050.  Non-Proctored exams in the SON are open resource.  Open resource includes, all class materials, textbooks, online materials and collaboration with other students, e.g., verbal, email, text, however students are responsible for their own academic work.   In the SON, students will be advised when an exam is non-proctored.

School of Nursing Catalog/Handbook

All students are responsible for following the policies and expectations outlined in the OHSU School of Nursing catalog/student handbook, including but not limited to the SON code of conduct and the minimum technology requirements.

Students are responsible for their own academic work. Students are expected to have read and practice principles of academic honesty, as presented in the School of Nursing catalog/student handbook.

The School of Nursing reserves the privilege of retaining only those students who, in the judgment of the faculty, satisfy the requirements of scholarship and clinical performance necessary for the safe practice of nursing. The SON Catalog & Student Handbook has information about academic standards and probation and dismissal policies.


Some courses in the School of Nursing use an academic authenticity tool called Turnitin. Turnitin is an originality checker used by some courses and programs in the School of Nursing at OHSU. Turnitin is one of many forms of feedback that can enable writers to develop skills in source integration and citation, as well as help writers avoid plagiarism. Complete instructions will be provided in the course site.

Technical Support

The OHSU ITG Help Desk is available to assist students with email account or network account access issues between 6 a.m. and 6 p.m., Monday through Friday at 503-494-2222. For technical support in using the Sakai Course Management System, please contact the Sakai Help Desk at 877-972-5249 or email us at [email protected]

SON: Campus Safety and Weather

OHSU Public Safety

SOU - Ashland Campus Public Safety

  • For Emergencies dial 911
  • Officer Assistance: (541) 552-6911

WOU - Monmouth Campus Public Safety

  • Emergency: 503-838-9000
  • Main Office (Open 24/7): 503-838-8481

EOU - La Grande Campus Public Safety

  • Emergency: 911
  • Camus Security Non Emergency: 541-962-3911

OIT - Klamath Falls Campus Public Safety

  • Emergency: 911 or 541-885-0911
  • Camus Security Non Emergency: 541-885-1111


Students should call OHSU’s weather alert line at 503-494-9021 for the most up-to-date information on OHSU-wide modified operations which include but are not limited to delays or closures for inclement weather. For specific campus information, outside of Portland, check the following sites:

OHSU Competencies

List of OHSU Graduation Core Competencies
  • Professional Knowledge and Skills
  • Professionalism
  • Information Literacy
  • Communication
  • Teamwork
  • Community Engagement, Social Justice and Equity
  • Patient Centered Care
To access a descriptive list of OHSU Graducation Core Competencies:  OHSU Graduation Core Competencies

Institutional Policies and Resources

Statement Regarding Students with Disabilities:

OHSU is committed to inclusive and accessible learning environments in compliance with federal and state law. If you have a disability or think you may have a disability (mental health, attention-related, learning, vision, hearing, physical or health impacts) contact the Office for Student Access at (503) 494-0082 or OHSU Student Access to have a confidential conversation about academic accommodations. Information is also available at Student Access Website. Because accommodations may take time to implement and cannot be applied retroactively, it is important to have this discussion as soon as possible.

Portland State students also have similar resources available via the PSU Disability Resource Center (website ). Please contact the DRC at tel. (503) 725-4150 or email at [email protected]

Student Evaluation of Courses:

Course evaluation results are extremely important and used to help improve courses and the learning experience of future students. Responses will always remain anonymous and will only be available to instructors after grades have been posted. The results of scaled questions and comments go to both the instructor and their unit head/supervisor. Refer to Student Evaluation of Courses and Instructional Effectiveness, *Policy No. 02-50-035.

*To access the OHSU Student Evaluation of Courses and Instructional Effectiveness Policy, you must log into the OHSU O2 website.

Copyright Information:

Copyright laws and fair use policies protect the rights of those who have produced the material. The copy in this course has been provided for private study, scholarship, or research. Other uses may require permission from the copyright holder. The user of this work is responsible for adhering to copyright law of the U.S. (Title 17, U.S. Code). To help you familiarize yourself with copyright and fair use policies, the University encourages you to visit its Copyright Web Page

Sakai course web sites contain material protected by copyrights held by the instructor, other individuals or institutions. Such material is used for educational purposes in accord with copyright law and/or with permission given by the owners of the original material. You may download one copy of the materials on any single computer for non-commercial, personal, or educational purposes only, provided that you (1) do not modify it, (2) use it only for the duration of this course, and (3) include both this notice and any copyright notice originally included with the material. Beyond this use, no material from the course web site may be copied, reproduced, re-published, uploaded, posted, transmitted, or distributed in any way without the permission of the original copyright holder. The instructor assumes no responsibility for individuals who improperly use copyrighted material placed on the web site.

Syllabi Changes and Retention:

Syllabi are considered to be a learning agreement between students and the faculty of record. Information contained in syllabi, other than the minimum requirements, may be subject to change as deemed appropriate by the faculty of record in concurrence with the academic program and the Office of the Provost. Refer to the *Course Syllabi Policy, 02-50-050.

*To access the OHSU Course Syllabus Policy, you must log into the OHSU O2 website.

Privacy While Learning Remotely

Students may be asked to take classes remotely through videoconferencing software like WebEx. Some of these remote classes will be recorded. Any recording will capture the presenter’s audio, video, and computer screen. Student video and audio will be recorded if and when you unmute your audio and share your video during the recorded sessions. These recordings will not be shared with or accessible to the public without prior written consent. 

Commitment to Diversity & Inclusion:

OHSU is committed to creating and fostering a learning and working environment based on open communication and mutual respect. If you encounter sexual harassment, sexual misconduct, sexual assault, or discrimination based on race, color, religion, age, national origin, veteran’s status, ancestry, sex, marital status, pregnancy or parenting status, sexual orientation, gender identity, disability or any other protected status please contact the Affirmative Action and Equal Opportunity Department at 503-494-5148 or [email protected]. Inquiries about Title IX compliance or sex/gender discrimination and harassment may be directed to the OHSU Title IX Coordinator at 503-494-0258 or [email protected].

Modified Operations, Policy 01-40-010:

Portland Campus:  Marquam Hill and South Waterfront

Students should review O2 or call OHSU’s weather alert line at 503-494-9021 for the most up-to-date information on OHSU-wide modified operations which include but are not limited to delays or closures for inclement weather.

If your home institution is not on the Portland campus (Marquam Hill or South Waterfront, contact your home institution for more information.

OHSU Resources Available to Students*:

Remote Learning Resources
The Remote Learning webpage on O2 contains concise, practical resources, and strategies for students that need to quickly transition to a fully remote instructional format.

Registrar’s Office
Mackenzie Hall, Rm. 1120
503-494-7800; Email the Registrar

Student Registration Information: 
To Register for Classes

OHSU ITG Help Desk
Regular staff hours are 6 a.m. to 6 p.m., Monday through Friday, but phones are answered seven days a week, 24 hours a day. Call 503 494-2222.

Teaching and Learning Center
Academic Support Counseling and Sakai Course Management System, please contact the TLC Help Desk at 877-972-5249 or email TLC Help Desk

Student Academic Support Services
For resources on improving student’s study strategies, time management, motivation, test-taking skills and more, Please access the Student Academic Support Services Sakai page. For one-on-one appointments or to arrange a workshop for students, please contact Emily Hillhouse.

Confidential Advocacy Program
Support for OHSU employees, students, and volunteers who have experienced any form of sexual misconduct, including sexual harassment, sexual assault, intimate-partner violence, stalking, relationship/dating violence, and other forms — regardless of when or where it took place. Contact Us.

Concourse Syllabus Management
For help with accessing your Concourse Syllabus:  Please contact the Sakai help Desk for all other Concourse inquiries please visit the Concourse Support - Sakai or please contact the Mark Rivera at [email protected] or call 503-494-0934

Public Safety
OHSU Public Safety-Portland Campus (Marquam Hill and South Waterfront)

Student Health & Wellness Center 
Baird Hall, Rm. 18 (Primary Care) and Rm. 6 (Behavioral Health)
503-494-8665; For urgent care after hours, 503-494-8311 and ask for the Nurse on call.
Wellness Center Information  
Wellness Center Website

If your home institution is not on the Portland campus, contact your home institution student support services for more information.

Ombudsman Office
Gaines Hall, Rm. 117
707 SW Gaines Street, Portland, OR 97239
503-494-5397; Contact OmbudsmanOmbudsman Website

Library: Biomedical Information Communication Center
BICC Library Hours of Operation