Integrating High-Value Care Concepts into Preclinical Medical Education: A Practical Approach

Magalie E Carey; Brittany L Gilmore; Michael J Lawler; Max Hoddwells; Andrew J Hale; Allen B Repp

doi:10.1177/23821205231173490

Integrating High-Value Care Concepts into Preclinical Medical Education: A Practical Approach

J Med Educ Curric Dev. 2023 May 4:10:23821205231173490. doi: 10.1177/23821205231173490. eCollection 2023 Jan-Dec.

Authors

Magalie E Carey¹, Brittany L Gilmore², Michael J Lawler², Max Hoddwells², Andrew J Hale³, Allen B Repp³

Affiliations

¹ Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
² The Robert Larner, MD College of Medicine at the University of Vermont, Burlington, Vermont, USA.
³ Department of Medicine, The Robert Larner, MD College of Medicine at the University of Vermont, Burlington, Vermont, USA.

Abstract

Objectives: Although some US medical schools have incorporated high-value care into their preclinical curriculum, there is no standardized approach and major curricular overhaul can be prohibitively onerous. The objectives of this study were to develop a feasible and effective high-value care curriculum, integrate it into an existing pre-clinical course, and assess student and faculty perceptions of the educational value of the curriculum.

Methods: Between 2019 and 2021, University of Vermont preclinical medical students participating in the Students & Trainees Advocating for Resource Stewardship (STARS) program collaborated with the faculty director of the preclinical pathophysiology course to identify Choosing Wisely® recommendations relevant to course topics. For each recommendation, STARS students created a case-based, multiple-choice question, answer key and rationale to accompany standard course materials. At each year's course completion, participating students and faculty were invited to complete a survey to assess their perceptions of the curriculum.

Results: Seventeen case-based questions were integrated into existing pathophysiology course sessions each year. Over the 3-year period, 420 students and 35 teaching faculty participated in the course, and 171 (40.7%) students and 24 (68.6%) faculty completed the post-course survey. Among student respondents, 80% agreed the curriculum increased their awareness of high-value care, 79% agreed they would be more likely to apply high-value care concepts during their medical career, and 92% agreed it was valuable to discuss Choosing Wisely® recommendations during the second year of medical school.

Conclusion: A student-led initiative to incorporate high-value care content within an existing pre-clinical course was well-received by medical students, who reported increased awareness of and intention to apply high-value care principles. This model may offer a feasible and effective approach to high-value care education in the absence of an extensive formal curriculum.

Keywords: curriculum; high value care; medical; schools; students.