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A High-Value Care Curriculum Using Individual and Group Structured Reflection.

Vanessa Ford1, Helena Frischtak1, Joesph R Wiencek1

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Medical students can identify low-value care and solutions when taught through a structured curriculum. This educational approach empowers them to contribute to high-value care discussions in clinical settings.

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Area of Science:

  • Medical Education
  • Health Economics
  • Clinical Practice

Background:

  • Significant healthcare spending is attributed to unnecessary diagnostic tests and treatments.
  • Medical education may perpetuate the issue of low-value care.
  • There is a need to train medical students in high-value care principles.

Purpose of the Study:

  • To develop and implement a curriculum for medical students focused on promoting high-value care.
  • To equip students with skills to identify and address low-value care in clinical practice.

Main Methods:

  • A 3-phase curriculum was implemented for third-year medical students during their Internal Medicine clerkship.
  • Students used a structured reflection framework to identify low-value care, propose solutions, and pinpoint barriers.
  • Reflective narratives were analyzed to identify patterns and themes.

Main Results:

  • 151 students participated in phase 1 and 119 in phase 3.
  • 126 reflective narratives (94.7% participation) identified 226 problems, 280 solutions, and 179 barriers.
  • Students demonstrated the ability to identify issues related to low-value care.

Conclusions:

  • Medical students can effectively identify low-value care examples, solutions, and implementation barriers.
  • A structured reflection curriculum, including narratives and debate, enhances students' contribution to high-value care.
  • This curriculum supports the development of clinicians committed to high-value healthcare practices.