Imprinting on Clinical Rotations: Multisite Survey of High- and Low-Value Medical Student Behaviors and Relationship with Healthcare Intensity

Hunderfund, Andrea N. Leep; Starr, Stephanie R.; Dyrbye, Liselotte N.; Baxley, Elizabeth G.; Gonzalo, Jed D.; Miller, Bonnie M.; George, Paul; Morgan, Helen; Allen, Bradley L.; Hoffman, Ari; Fancher, Tonya L.; Mandrekar, Jay; Reed, Darcy A.

doi:10.1007/s11606-019-04828-8

Cited by 18 publications

(25 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…should be taught as early as possible. (14) This study demonstrated that medical students can apply concepts taught to them in simulated clinical scenarios which are not part of the formal curriculum.…”

Section: Discussionmentioning

confidence: 84%

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Pahwa

Eaton

Apfel

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: While there are increasing curricula on high value care, little is published on the effectiveness of 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: One hundred forty-one students enrolled in the Core Clerkship in Internal Medicine and 69 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 were not significantly different, students in the intervention group refrained from ordering expensive tests.

show abstract

Section: Discussionmentioning

confidence: 84%

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Pahwa

Eaton

Apfel

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Students in high intensity regions are more likely to display low-value behaviors thus high value care should be taught as early as possible [13]. The healthcare intensity is a measure developed by the Dartmouth Atlas the amount of care a Medicare beneficiary received in the last 2 years of their life.…”

Section: Discussionmentioning

confidence: 99%

Effect of a high value care curriculum on standardized patient exam in the Core Clerkship in Internal Medicine

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

“…should be taught as early as possible. (13) The healthcare intensity is a measure developed by the Dartmouth Atlas the amount of care a Medicare bene ciary received in the last two years of their life. For JHH, the healthcare intensity is approximately the 50 th percentile.…”

Section: Discussionmentioning

confidence: 99%

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Pahwa

Eaton

Apfel

et al. 2020

Preprint

View full text Add to dashboard Cite

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.

show abstract

Imprinting on Clinical Rotations: Multisite Survey of High- and Low-Value Medical Student Behaviors and Relationship with Healthcare Intensity

Cited by 18 publications

References 41 publications

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Effect of a high value care curriculum on standardized patient exam in the Core Clerkship in Internal Medicine

Effect of a High Value Care Curriculum on Standardized Patient Exam in the Core Clerkship in Internal Medicine

Contact Info

Product

Resources

About