Teaching high-value care: a novel morning report

Area of Science:

• Medical Education
• Health Economics
• Internal Medicine Training

Background:

• Rising healthcare costs necessitate integrating high-value care (HVC) principles into medical education.
• Existing curricula for teaching HVC to medical trainees are limited.

Purpose of the Study:

• To evaluate the impact of a morning report focused on HVC on internal medicine trainees.
• To assess changes in trainees' knowledge of diagnostic test costs and their intended future ordering practices.

Main Methods:

• A single-group pre/post comparison design was used.
• A 45-minute morning report session incorporating a budget-constrained diagnostic case was implemented.
• Trainees completed pre/post surveys on HVC knowledge, attitudes, and ordering intentions, along with an intervention evaluation.

Main Results:

• Significant increases were observed in trainees' self-reported understanding of diagnostic test costs (p < 0.001).
• Trainees reported a higher likelihood that cost would influence future ordering practices (p < 0.001) and timing of evaluations (p ≤ 0.001).
• A significant decrease in the likelihood of ordering extra diagnostic evaluations was noted (p = 0.015), with 96% finding the session educationally valuable.

Conclusions:

• A morning report integrating the cost of care can effectively enhance trainees' cost awareness.
• This educational intervention significantly influences self-reported ordering practices among trainees.
• The HVC morning report is a valuable and impactful educational tool for medical training.