Background: Teaching the practice of high-value care (HVC) is an increasingly important function of graduate medical education but best practices and long-term outcomes remain unknown.

    Objective: Whether a multimodal curriculum designed to address specific drivers of low-value care would affect resident attitudes, skills, and performance of HVC as tested by the Internal Medicine In-Training Exam (ITE).

    Methods: In 2012, we performed a baseline needs assessment among internal medicine residents at a community program regarding drivers of healthcare utilization. We then created a multimodal curriculum with online interactive worksheets, lectures, and faculty buy-in to target specific skills, knowledge, and culture deficiencies. Perceived drivers of care and performance on the Internal Medicine ITE were assessed yearly through 2016.

    Results: Fourteen of 27 (52%) residents completed the initial needs assessment while the curriculum was eventually seen by at least 24 of 27 (89%). The ITE was taken by every resident every year. Long-term, 3-year follow-up demonstrated persistent improvement in many drivers of utilization (patient requests, reliance on subspecialists, defensive medicine, and academic curiosity) and improvement with sustained high performance on the high-value component of the ITE.

    Conclusion: A multimodal curriculum targeting specific drivers of low-value care can change culture and lead to sustained improvement in the practice of HVC.


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    Title :

    A multimodal high-value curriculum affects drivers of utilization and performance on the high-value care component of the internal medicine in-training exam


    Contributors:


    Publication date :

    2018-01-02


    Size :

    3 pages




    Type of media :

    Article (Journal)


    Type of material :

    Electronic Resource


    Language :

    English