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Background: Process improvement (PI) science is relatively new to healthcare and has only recently been introduced to medical education. Most residency faculty lack training or experience in PI science activities. We assessed the impact of PI science education on the knowledge and attitudes of a group of residency and fellowship program directors and associate program directors using their respective Accreditation Council for Graduate Medical Education annual program evaluations (APEs) as an experiential object., Methods: For this pre/post study, 16 program directors and 7 associate program directors were surveyed before and after 4 didactic modules. The APEs for the 2 years prior to the intervention and in the fall after the intervention were analyzed. Mentoring in the use of these skills in the preparation of the APEs was provided., Results: The participants demonstrated improved knowledge in some areas and increased awareness of deficits in other areas. APE quality did not show consistent improvement following the intervention., Conclusion: The PI science knowledge and skill gaps of program directors and associate program directors are likely to impact the content and success of residency curricula. The designed PI science curriculum was slightly effective. Using the APE as the experiential object was convenient, but the APE was not the best project for a PI exercise. New, effective strategies and interventions to develop expertise in PI science are important as programs grapple with meeting new requirements, ensuring quality programs, and preparing residents and fellows for practice.