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标题：Infusing High Value Care Education Directly into Patient Care on the Medicine Wards
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作者：Jacqueline M. Schulman ; Sonali Palchaudhuri ; Brandyn D. Lau 等
期刊名称：MedEdPublish
电子版ISSN：2312-7996
出版年度：2019
卷号：8
期号：2
页码：1-9
DOI：10.15694/mep.2019.000136.1
出版社：Association for Medical Education in Europe (AMEE)
摘要：Background: Multiple national initiatives have been implemented to promote cost-conscious care. Yet, there remains a deficiency of formal high value care (HVC) curricula among internal medicine residency programs. We aimed to develop a curriculum that teaches HVC material that can be utilized at the point of care and to assess the curriculum’s impact on the participants’ attitudes, knowledge, and practice patterns pertaining to HVC.Methods: We conducted our study on the inpatient internal medicine service over two-week rotations at Johns Hopkins Bayview Medical Center. Internal medicine residents participated in two collaborative educational sessions that incorporated an introduction of important concepts in HVC, Bayesian thinking, clinical cases, and a review of a hospital bill of one of the patients under the team’s care. Participants were also encouraged to reflect on their practice patterns and incorporate the HVC principles taught into their daily clinical work. We administered pre- and post-curriculum surveys to assess change in reported HVC-related practice behaviors, knowledge, and attitudes.Results: Forty-seven residents participated in the study. We included the twenty participants who completed both a pre- and post-curriculum survey in the data analysis. After participation in the curriculum, there was a significant increase in the use of pre-test probabilities in clinical decision making (p=0.005). There was also a trend toward improvement in HVC knowledge and practice patterns after the rotation.Conclusion: We implemented a curriculum thatmay have improved high-value practice patterns through point-of-care education on the inpatient medicine wards.
关键词：High value care; medical residency; graduate medical education; point of care teaching