BACKGROUND: In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. OBJECTIVE: To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. METHODS: A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes. RESULTS: A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P = .015). CONCLUSIONS: The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.
BACKGROUND: In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process. OBJECTIVE: To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults. METHODS: A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes. RESULTS: A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P = .015). CONCLUSIONS: The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.
Authors: Maartje H J Swennen; Geert J M G van der Heijden; Hennie R Boeije; Nanda van Rheenen; Floor J M Verheul; Yolanda van der Graaf; Cor J Kalkman Journal: Acad Med Date: 2013-09 Impact factor: 6.893
Authors: S R Weingarten; M S Riedinger; L Conner; T H Lee; I Hoffman; B Johnson; A G Ellrodt Journal: Ann Intern Med Date: 1994-02-15 Impact factor: 25.391
Authors: Lorette A Stammen; Renée E Stalmeijer; Emma Paternotte; Andrea Oudkerk Pool; Erik W Driessen; Fedde Scheele; Laurents P S Stassen Journal: JAMA Date: 2015-12-08 Impact factor: 56.272
Authors: Mary Simons; Frances Rapport; Yvonne Zurynski; Marcus Stoodley; Jeremy Cullis; Andrew S Davidson Journal: BMJ Open Date: 2022-04-25 Impact factor: 3.006