Value-Based Health Care in Undergraduate Medical Education.

Autor:	Holtzman JN; J.N. Holtzman is an internal medicine resident, University of California, San Francisco, San Francisco, California; ORCID: http://orcid.org/0000-0002-1721-1512. B.R. Deshpande is a fourth-year medical student, Harvard Medical School, Boston, Massachusetts. J.C. Stuart is an internal medicine resident, Brigham and Women's Hospital, Boston, Massachusetts. T.W. Feeley is a senior fellow, Institute for Strategy and Competitiveness, Harvard Business School, Boston, Massachusetts, and professor emeritus of anesthesiology, University of Texas MD Anderson Cancer Center, Houston, Texas. M. Witkowski is a fellow, Institute for Strategy and Competitiveness, Harvard Business School, Boston, Massachusetts. E.M. Hundert is dean for medical education, and the Daniel D. Federman, M.D. Professor in Residence of Global Health and Social Medicine and Medical Education, Harvard Medical School, Boston, Massachusetts. J. Kasper is assistant professor of global health and social medicine, Harvard Medical School, Boston, Massachusetts., Deshpande BR, Stuart JC, Feeley TW, Witkowski M, Hundert EM, Kasper J
Jazyk:	angličtina
Zdroj:	Academic medicine : journal of the Association of American Medical Colleges [Acad Med] 2020 May; Vol. 95 (5), pp. 740-743.
DOI:	10.1097/ACM.0000000000003150
Abstrakt:	Problem: Value-based health care (VBHC) is an innovative framework for redesigning care delivery to achieve better outcomes for patients and reduce cost; however, providing students with the skills to understand and engage with these topics is a challenge to medical educators. Approach: Here, the authors present a novel, VBHC curriculum integrated into a required course for post-core clerkship students-launched in 2018 at Harvard Medical School and taught in conjunction with Harvard Business School faculty-that highlights key principles of VBHC most relevant to undergraduate medical education. The course integrates VBHC with related health disciplines, including health policy, ethics, epidemiology, and social medicine, using a case-based method. Students practice active decision making while learning key concepts to address value in clinical practice. Outcomes: Since the course's inception in March 2018, 95 students (87%) completed the standardized course evaluation; the majority said VBHC content and pedagogical style (i.e., case-based learning) enhanced their learning. Students' critiques focused on too little integration with other disciplines (e.g., social medicine, ethics), the physical space, and inadequate time for debates about potential tensions between VBHC and other course disciplines. Next Steps: The authors believe that by exposing medical students to the principles of VBHC, students will fulfill the expectations of graduating physicians by excelling as critical thinkers, collaborative team members, and judicious care providers throughout their residency, clinical practice, and beyond. Future VBHC curricula expansions may include elective coursework, intensive seminar series, and formal dual degrees.
Databáze:	MEDLINE
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