BACKGROUND : Quality improvement is increasingly becoming an essential aspect of the medical curriculum, with
the intention of improving the health care system to provide better health care. The aim of this study was to
explore undergraduate medical students’ experiences of their involvement in quality improvement projects during a
district health rotation.
METHODS : Student group reports from rotations in learning centres of the University of Pretoria in Mpumalanga
Province, South Africa were analysed for the period 2012 to 2015. Interviews were conducted with health care
providers at four learning centres in 2013.
RESULTS : Three main themes were identified: (1) ‘Situated learning’, describing students’ exposure to the discrepancies
between ideal and reality in a real-life situation and how they learned to deal with complex situations, individually and
as student group; (2) ‘Facing dilemmas’, describing how students were challenged about the non-ideal reality; (3)
‘Making a difference’, describing the impact of the students’ projects, with greater understanding of themselves
and others through working in teams but also making a change in the health care system.
CONCLUSION : Quality improvement projects can provide an opportunity for both the transformation of health care
and for transformative learning, with individual and ‘collective’ self-authorship.