Value-Based Health Care in Undergraduate Medical Education

Abstract

Does not collect accurate historical data Relies exclusively on secondary sources or documentation of others Is disrespectful in interactions with patients Disregards patient privacy and autonomy Fails to recognize patient's central problem Does not consider patient's privacy and comfort during exams Incorrectly performs basic physical exam maneuvers Key Functions with Related Competencies Obtain a complete and accurate history in an organized fashion PC2 Demonstrate patient-centered interview skills ICS1 ICS7 P1 P3 P5 Demonstrate clinical reasoning in gathering focused information relevant to a patient's care KP1 Perform a clinically relevant, appropriately thorough physical exam pertinent to the setting and purpose of the patient visit PC2 Gather a history and perform a physical exam EPA 1 EPA 1: Gather a History and Perform a Physical Examination Underlying entrustability for all EPAs are trustworthy habits, including truthfulness, conscientiousness, and discernment. An EPA: A unit of observable, measurable professional practice requiring integration of competencies Barron, B, Orlander, P, Schwartz, ML. Obeso V, Brown D, Phillipi C, eds.; for Core EPAs for Entering Residency Pilot Program Adapted from the Association of American Medical Colleges (AAMC). Core entrustable professional activities for entering residency. 2014. This schematic depicts development of proficiency in the Core EPAs. It is not intended for use as an assessment instrument. Entrustment decisions should be made after EPAs have been observed in multiple settings with varying context, acuity, and complexity and with varying patient characteristics. PATIENT CARE (PC):Provide patient-centered care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health 1.1 Perform all medical, diagnostic, and surgical procedures considered essential for the area of practice 1.2 Gather essential and accurate information about patients and their condition through historytaking, physical examination, and the use of laboratory data, imaging, and other tests 1.3 Organize and prioritize responsibilities to provide care that is safe, effective, and efficient 1.4 Interpret laboratory data, imaging studies, and other tests required for the area of practice 1.5 Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment 1.6 Develop and carry out patient management plans 1.7 Counsel and educate patients and their families to empower them to participate in their care and enable shared decision making 1.8 Provide appropriate referral of patients, including ensuring continuity of care throughout transitions between providers or settings and following up on patient progress and outcomes 1.9 Provide health care services to patients, families, and communities aimed at preventing health problems or maintaining health 1.10 Provide appropriate role modeling 1.11 Perform supervisory responsibilities commensurate wi...

Pre‐doctoral dental faculty perceptions toward value‐based care: An exploratory study

“…35,36 Two medical schools utilized case-based methods to incorporate VBC into their curriculum. 36,37 These studies align with the suggestions from the faculty interviews that real-life experiences should be used to teach VBC. Holtzman et al suggest that VBC curricula include elective coursework, seminar series, and formal dual degrees.…”

Medical Students’ Awareness About Value-Based Health Care in Brazil: A Cross Sectional Study

“…The course is organized around six domains, one being the High-Value Domain, which focuses on three main desired outcomes: applying scientific literature in patient care, improving the system, and balancing quality and cost in patient care. 16 In HMS, students take two fourweek courses. The first one, applied during the first year of medical school, covers foundational topics in clinical epidemiology and population health, health policy, social medicine and medical ethics.…”

“…The second (after a minimum of 12 months of clinical rotations) includes advanced topics in these disciplines, and is taken in collaboration with Harvard Business School (HBS), using the case method, with which they provide detailed information about a single organization to focus in-class discussions around key elements of VBHC. 16 Furthermore, a significant proportion of the students familiar with VBHC concepts share intrinsic traits, partially dependent on medical schools. Interest in following a career in management and a desire to pursue an MBA almost doubles the likelihood of a student being familiar with VBHC, 11.74% vs 6.06% and 19.95% vs 8.47%, respectively.…”

Incorporating value-based healthcare projects in residency training: a mixed-methods study on the impact of participation on understanding and competency development

“…13 Medical students and residents must be educated and trained in settings where they have opportunities to develop and use VBHC, preferably a clinical setting. [16][17][18] Among others, a specific training programme, incorporating formal and informal learning, is necessary to learn how to deliver VBHC. 19 The residency training programmes are believed to be one of the best places to initiate VBHC education because residents are adaptable, highly educated and motivated.…”

“…As recent research had illustrated, past efforts to teach residents about cost-effective care have unfortunately not always been as effective as intended,13–15 and that key elements of learning to deliver VBHC are knowledge transmission, appropriate role modelling, reflection and the presence of a supportive environment 13. Medical students and residents must be educated and trained in settings where they have opportunities to develop and use VBHC, preferably a clinical setting 16–18. Among others, a specific training programme, incorporating formal and informal learning, is necessary to learn how to deliver VBHC 19.…”