Background Previous faculty-driven residents-as-teachers (RAT) models have had limited efficacy and sustainability. Objective To evaluate the acceptability and effects of a resident-led RAT program on resident teaching. Methods In October 2016, obstetrics and gynecology (OB/GYN) residents at a large academic institution implemented a resident-led RAT program, consisting of a steering committee of peer-selected residents with 2 faculty mentors who planned education-focused resident didactics and journal clubs, organized resident involvement in clerkship activities, and recognized residents who excelled in teaching as Distinguished Educators (DEs). From July 2016 through June 2019, using the Kirkpatrick Model, we evaluated the program with annual resident surveys assessing self-perception of 13 teaching skills (5-point Likert scale) and value of RAT program, institutional end-of-clerkship student evaluations of resident teaching, and resident participation in DE award. Results Annual resident survey response rates ranged from 63% to 88%. Residents' self-reported teaching skills improved significantly in 11 of 13 domains from 2016 to 2018 (improvements ranging from 0.87–1.42; 5-point Likert scale; P < .05). Of the 2018 respondents, 80% agreed that the resident-led RAT program added value to the residency. For 2017–2018 and 2018–2019 academic years, 47% and 48% of medical students (100% response rate) strongly agreed that residents provided effective teaching compared to 30% in 2016–2017 (P < .05). Ten residents have graduated as DEs during this time period. Conclusions A resident-led RAT program increased residents' self-reported teaching skills, improved medical student perceptions of teaching quality, and was sustainable and acceptable over a 3-year period.

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Objectives Promotion of high-quality care at a lower cost requires educational initiatives across the continuum of medical education. A needs assessment was performed to inform the design of an educational tool with the goal of teaching laboratory stewardship to medical students. Methods The needs assessment consisted of semistructured interviews with core clerkship directors and residency program directors at our institution, a national survey to the Undergraduate Medical Educators Section (UMEDS) of the Association of Pathology Chairs, and a review of existing online resources that teach high-value care. Results Two major themes emerged regarding opportunities to enhance laboratory stewardship education: appropriate ordering (knowledge of test indications, pretest/posttest probability, appropriateness criteria, recognition of unnecessary testing) and correct interpretation (understanding test specifications, factors that affect the test result, recognizing inaccurate results). Conclusions The online educational tool will focus on the curricular needs identified, using a multidisciplinary approach for development and implementation.

Context.-Current health care spending is unsustainable, and there is a need to teach high-value care principles to future physicians. Pathology-Teaches is an educational intervention designed to teach laboratory stewardship early in clinical training, at the level of the medical student in their core clinical clerkships.Objective.-To assess the pilot implementation of casebased educational modules in 5 required core clerkships at our institution.Design.-The online cases were developed by using a multidisciplinary approach. In the Pathology-Teaches educational module, students make decisions regarding the ordering or interpretation of laboratory testing within the context of a clinical scenario and receive immediate feedback during the case. The intervention was assessed by using pretest and posttest. Student feedback was also collected from end-of-rotation evaluations.Results.-A total of 203 students completed the Pathology-Teaches pilot, including 72 in Family Medicine, 72 in Emergency Medicine, 24 in Internal Medicine, 24 in Neurology, and 11 in Obstetrics-Gynecology (OB-GYN). Pathology-Teaches utility was demonstrated by significantly increased improvement between pretest and posttest scores (mean, 63.1% versus 83.5%; P , .001; Hedge g effect size ¼ 0.93). Of the 494 students who completed the Pathology-Teaches questions on the end-of-rotation evaluation, 251 provided specific feedback, with 38.6% (97 of 251) rating the activity as ''extremely valuable '' or ''very valuable,'' and 41.4% (104 of 251) as ''some/moderate value.'' Qualitative feedback included 17 positive comments with 6 requests to scale up or include more cases, 16 constructive comments for improvement mainly regarding the technical aspects, and 5 negative comments.Conclusions.-Pathology-Teaches effectively teaches stewardship concepts, and most students perceived value in this educational intervention.