Pediatric Training Faculty and Resident Perceptions on Teaching High-Value, Cost-Conscious Care: A Multi-Institutional Study

King, Brian; DiPace, Jennifer; Naifeh, Monique; Hammad, Hoda T.; Gerber, Linda M.; Abramson, Erika L.

doi:10.1542/hpeds.2017-0037

Cited by 8 publications

(9 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Dutch residents, much like residents in other countries, are challenged to provide high-value care and take the costs into account. 18,33 Answering the first research question, we found that residents' learning was driven by their personal beliefs regarding HV3C, which led to equally different responses to HV3C-related dilemmas in clinical practice. When designing curricula, it is important to acknowledge different beliefs of residents and how these beliefs influence their HV3C learning.…”

Section: Discussionmentioning

confidence: 95%

“…Role modeling HV3C is known to be scarce in residency training, due to lack of personal knowledge and training. 18 Specific training may be required, teaching physicians to become effective role models of HV3C. It is not surprising that today's academic faculty experience difficulties in teaching HV3C delivery, considering that they themselves were not trained in these competencies.…”

Section: Discussionmentioning

confidence: 99%

“…14 Despite the intentions of directors to offer HV3C training, incorporating it in postgraduate medical training programs progresses slowly 15,16 due to the complexity of designing training aimed at effective knowledge transmission and reflective practice within an unsupportive environment. 14,17,18 A supportive environment is essential, as the hidden curriculum is known to hamper successful transfer of known skills into the workplace. 19 Informal education matters, as residents spend most of their training in clinical settings and messages in the hidden curriculum can be far more powerful than the lessons taught by formal curricula.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

Stammen

Slootweg

Stalmeijer

et al. 2019

Teaching and Learning in Medicine

View full text Add to dashboard Cite

Phenomenon: Rising healthcare expenditures threaten the accessibility and affordability of healthcare systems. Research has demonstrated that teaching (junior) physicians to deliver high-value, cost-conscious care can be effective when learning is situated in a supportive environment. This study aims to offer insight into how residents learn to provide high-value, cost-conscious care in the workplace and how the postgraduate training environment influences this learning. Approach: Six homogeneous focus groups were held between August 2015 and July 2016 with 36 residents from six residency programs (dermatology, n ¼ 5; elderly care, n ¼ 8; family medicine, n ¼ 5; internal medicine, n ¼ 6; orthopedic surgery, n ¼ 6; surgery, n ¼ 6). An iterative grounded theory approach was used to analyze the qualitative data. Findings: Influential factors in learning of high-value, cost-conscious care delivery operated on three levels: individual resident, training program, and the workplace. On the individual level, we discerned three types of beliefs regarding HV3C. At the training program level, perceived determinants of learning included resident-supervisor interactions, involvement in decision-making over time, and exposure to variation in care delivery. At the workplace level, learning depended on the availability of professional healthcare expertise and the presence of institutional policy. Insights: Residents struggle to seize high-value, cost-conscious care learning opportunities in the workplace setting. Both residency training programs and workplaces can contribute to creating these learning opportunities. An important starting point is being aware of the different personal beliefs of residents and the approaches to high-value, cost-conscious care on the level of the training program and workplace.

show abstract

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Struggle Is Real: How Residents Learn to Provide High-Value, Cost-Conscious Care

Stammen

Slootweg

Stalmeijer

et al. 2019

Teaching and Learning in Medicine

View full text Add to dashboard Cite

show abstract

“…35 36 The finding that residents value the inclusion of VBHC in educational plans positively confirms that they consider it an important topic that should be part of postgraduate medical education. 7 However, VBHC as a precondition for audits is not preferred. This might perhaps be due to the assumption that the inclusion in educational plans is less strict and binding compared to the theme being a precondition in postgraduate medical education quality assurance and audit procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Residents acknowledge the importance of VBHC and think that training institutions are responsible to address this topic. 7 Some of the leading national physician associations, such as The American College of Physicians and the American Board of Internal Medicine, share this view, resulting in the development of curricula that promote VBHC. 1 8– 10 Additionally, incorporating VBHC in postgraduate medical education has shown to be effective regarding training and stimulating non-medical (CanMEDs) competencies, thereby positively affecting the development of skills as medical expert, leader, communicator and collaborator.…”

Section: Introductionmentioning

confidence: 99%

Discrete choice experiment on educating value-based healthcare

Noben

Stammen

Vaassen

et al. 2020

Postgraduate Medical Journal

View full text Add to dashboard Cite

IntroductionIdentifying costs and values in healthcare interventions as well as the ability to measure and consider costs relative to value for patients are pivotal in clinical decision-making and medical education. This study explores residents’ preferences in educating value-based healthcare (VBHC) during postgraduate medical education. Exploring residents’ preferences in VBHC education, in order to understand what shapes their choices, might contribute to improved medical residency education and healthcare as a whole.MethodsA discrete choice experiment (DCE) examined which conditions for educating VBHC are preferred by residents. DCE gives more insight into the trade-off’s residents make when choosing alternatives, and which conditions for educating VBHC have the most influence on residents’ preference.ResultsThis DCE shows that residents prefer knowledge on both medical practice as well as the process of care—to be educated by an expert on VBHC together with a clinician. They prefer limited protected time to conduct VBHC initiatives (thus while at work) and desire the inclusion of VBHC in formal educational plans.ConclusionWhen optimising graduate and postgraduate medical education curricula, these preferences should be considered to create necessary conditions for the facilitation and participation of residents in VBHC education and the set-up of VBHC initiatives.

show abstract