Mary Lacy1, Leonard Noronha1. 1. Department of Internal Medicine, University New Mexico School of Medicine, Albuquerque, New Mexico, USA.
Abstract
BACKGROUND: Physicians have an opportunity to address rising health care costs by optimising resource use. Recent research suggests that regional spending patterns influence student engagement with high- and low-value behaviours, revealing that these behaviours may be adopted early in training. The major curriculum for the internal medicine clinical experience does not address high-value care (HVC). At our institution, senior medical students in the subinternship of internal medicine have an increased responsibility in the development and implementation of patient management plans. OBJECTIVE: Our study aimed to determine whether a curriculum on HVC delivered to senior medical students would have a lasting impact on the students. METHODS: We implemented a curriculum in HVC for medical students and surveyed them before and after the curriculum as well as prior to graduation about their perceptions and engagement with HVC practices. RESULTS: We found a statistically significant increase in positive attitudes and reported perception of practice in senior medical students who received the curriculum; this was sustained prior to graduation. CONCLUSIONS: Our study supports the notion that a curriculum in HVC can increase reported HVC practices. Further research should be carried out to assess the impact of efforts to teach medical students about limiting unnecessary care within our medical system.
BACKGROUND: Physicians have an opportunity to address rising health care costs by optimising resource use. Recent research suggests that regional spending patterns influence student engagement with high- and low-value behaviours, revealing that these behaviours may be adopted early in training. The major curriculum for the internal medicine clinical experience does not address high-value care (HVC). At our institution, senior medical students in the subinternship of internal medicine have an increased responsibility in the development and implementation of patient management plans. OBJECTIVE: Our study aimed to determine whether a curriculum on HVC delivered to senior medical students would have a lasting impact on the students. METHODS: We implemented a curriculum in HVC for medical students and surveyed them before and after the curriculum as well as prior to graduation about their perceptions and engagement with HVC practices. RESULTS: We found a statistically significant increase in positive attitudes and reported perception of practice in senior medical students who received the curriculum; this was sustained prior to graduation. CONCLUSIONS: Our study supports the notion that a curriculum in HVC can increase reported HVC practices. Further research should be carried out to assess the impact of efforts to teach medical students about limiting unnecessary care within our medical system.
Authors: Nicholas S Duca; Cindy J Lai; Temple A Ratcliffe; Irene Alexandraki; Nadia Ismail; Michael Kisielewski; Jackcy Jacob; Katherine Walsh; Diane L Levine; Karen Szauter; Harish Jasti; Amber T Pincavage; Jeffrey LaRochelle; Susan A Glod Journal: J Gen Intern Med Date: 2021-09-20 Impact factor: 6.473