Kimberly L. O'Hara,Children's Hospital Colorado,Aurora,Colorado,Amanda . Burch,Children's Hospital Colorado,Aurora,CO,Michael D. Baca,Children's Hospital Colorado,Aurora,CO,Sonja . Ziniel,Children's Hospital Colorado,Aurora,CO,Jennifer B. Soep,Children's Hospital Colorado,Aurora,CO,Meghan . Treitz,Children's Hospital Colorado,Aurora,CO
Healthcare costs in the United States are increasing at an unsustainable rate1, with $210 billion spent on unnecessary services2. Physicians are responsible for directing much of this spending3. Our graduating medical students reported being least competent in incorporating cost awareness principles in clinical judgments. The need to provide education on high value care (HVC) is critical, particularly for medical students who are developing practice behaviors and can serve as stewards of resource utilization.
To develop, implement, and evaluate a curriculum on high value, cost-conscious medicine for fourth-year medical students completing a Pediatric Sub-Internship
To date, 26 students, including 5 students from other institutions, completed the curriculum. 92% of students rated the overall educational experience as excellent or very good. Self-perceived knowledge, attitudes and skills related to HVC improved (Figure 1). 96% completely or mostly agreed with feeling prepared to incorporate cost awareness principles in clinical judgments. Twenty-six fishbone diagrams met all criteria on the scoring checklist. All students demonstrated effective communication skills as rated by a validated scoring instrument (75% earned an 8-9/9, 25% scored 7-7.5/9). Reflective themes from content analysis included: shared-decision making, evidence-based medicine, role of consultants, communication, cultural norms, and change in practice.
Results will be re-analyzed before the COMSEP meeting to incorporate data from additional students.Discussion:
We successfully developed, implemented, and evaluated a HVC curriculum using multiple educational strategies and innovative modules. This curriculum is unique as it is geared towards trainees, focuses on Pediatrics, and can be completed during a four-week rotation. Asynchronous components allow for flexibility and easy maintenance of curriculum. Current efforts for curriculum enhancement include adding instruction on hospital finances and increased charge transparency. As healthcare evolves from volume to value, this curriculum provides trainees with the education and tools needed to practice healthcare resource stewardship.