Effect of a high value care curriculum on standardized patient exam in the Core Clerkship in Internal Medicine
- PDF / 515,137 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 55 Downloads / 173 Views
RESEARCH ARTICLE
Open Access
Effect of a high value care curriculum on standardized patient exam in the Core Clerkship in Internal Medicine Amit K. Pahwa1* , Kevin Eaton2, Ariella Apfel3, Amanda Bertram4, Rebecca Ridell5 and Danelle Cayea6
Abstract Background: With almost 20% unnecessary spending on healthcare, there has been increasing interest in high value care defined as the best care for the patient, with the optimal result for the circumstances, delivered at the right price. The American Association of Medical Colleges recommend that medical students are proficient in concepts of cost-effective clinical practice by graduation, thus leading to curricula on high value care. However little is published on the effectiveness of these curricula on medical students’ ability to practice high value care. Methods: In addition to the standard curriculum, the intervention group received two classroom sessions and three virtual patients focused on the concepts of high value care. The primary outcome was number of tests and charges for tests on standardized patients. Results: 136 students enrolled in the Core Clerkship in Internal Medicine and 70 completed the high value care curriculum. There were no significant differences in ordering of appropriate tests (3.1 vs. 3.2 tests/students, p = 0.55) and inappropriate tests (1.8 vs. 2.2, p = 0.13) between the intervention and control. Students in the intervention group had significantly lower median Medicare charges ($287.59 vs. $500.86, p = 0.04) and felt their education in high value care was appropriate (81% vs. 56%, p = 0.02). Conclusions: This is the first study to describe the impact of a high value care curriculum on medical students’ ordering practices. While number of inappropriate tests was not significantly different, students in the intervention group refrained from ordering expensive tests. Keywords: Clerkships, High value care, Medical student, Standardized patient
Background Compared to other developed countries, the United States has inferior health outcomes despite having the highest health care expenditure per capita in the world [1]. While some of the health expenditures could be attributed to higher prices, almost 20% is considered unnecessary spending [2, 3]. Because of this, there has been a movement to increase high value care (HVC), which is defined * Correspondence: [email protected] 1 Division of Hospital Medicine, Division of General Pediatrics, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA Full list of author information is available at the end of the article
by the Institute of Medicine as the best care for the patient, with the optimal result for the circumstances, delivered at the right price [4]. Understanding the importance of HVC education in medical school, the American Association of Medical Colleges recommended that medical students demonstrate proficiency in the concepts of cost-effective clinical practice upon graduation [5]. As a result, most medical schools have required coursework on cost
Data Loading...
