Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Poster Presentation:

Student Perceptions of High Value Care Cases

Starla Martinez,Northeast Ohio Medical University,Akron,OH,Heather Harrell,University of Florida,Gainesville,FL,Shauni Goodwin,MedU,Hanover,NH

Background: Approximately 30% of health care spending is for wasteful or potentially harmful medical services. Physicians are responsible for the majority of decisions that lead to this waste and harm.1  Specialty societies have embraced the need to improve value through the Choosing Wisely and High Value Care (HVC) campaigns.2,3 The LCME has enhanced its curricular requirements in areas that relate to HVC without reducing the curriculum otherwise, leading to limited time to cover HVC topics.   Medical students are interested in providing high value care but often have limited exposure to practical application of HVC concepts.  The HVC cases from MedU, available free to any learner, provides a foundation for understanding HVC principles at a time when students are developing clinical decision-making skills.

Objective:  To assess students’ perception of the relevance of the HVC cases to their learning and to determine whether specific cases enhance their preventive care knowledge.

Method: MedU (including COMSEP members), ACP, and AAIM collaborated to develop an on-line, interactive set of HVC cases for medical students.4 Cases use clinical situations to demonstrate integration of HVC concepts into clinical decision-making.  Clinicians model thoughtful use of testing and treatment, evaluation of financial costs, benefit vs. harm, incidental findings, and downstream consequences. National HVC guidelines are emphasized throughout.

To assess the effectiveness of the cases, four optional post-case questions were included that address the relevance, level of information, students’ recall of key points and utility of cases to add to students’ baseline knowledge of preventive care.

Results and Discussion:  These cases comprise a curriculum that has broad application.  Students have expressed interest in learning about HVC and seem to find the cases appealing.   Since the July 2014 launch, 1888 users have accessed the curriculum. Data are currently being collected to measure student’s perception of the HVC cases and will be available by January 2016, should this poster be accepted.

1. Committee on the Learning Health Care System in America. Best Care at Lower Cost.  The Path to Continuously Learning Health Care in America: Institute of Medicine of the National Academies; 2012.

2. Cassel CK, Guest JA. Choosing wisely: helping physicians and patients make smart decisions about their care. JAMA : the journal of the American Medical Association 2012;307:1801-2.

3. Smith CD. Teaching high-value, cost-conscious care to residents: the Alliance for Academic Internal Medicine-American College of Physicians Curriculum. Annals of internal medicine 2012;157:284-6.

4. High Value Care. 2014. (Accessed July 29, 2014, at