From the 2021 HVPAA National Conference
Lauren Pomerantz (Penn State College of Medicine), Kira Garry, Zachary Corey, Garrett Thompson, Lisa Yoder, Brian McGillen
Background
Student-organized educational initiatives highlight topics that may not be covered within traditional curricula and encourage learners to engage in innovative educational strategies. Interactive programs, like Hackathons, offer educational opportunities to integrate health systems concepts in medical students’ and physicians’ knowledge base [1,2]. As high-value care becomes central to a physician’s practice, there is a need for medical students to understand high-value fundamentals. With early and consistent exposure to the identification and remediation of low-value care, it is our aim that medical students will be equipped with the proper skills and empowered to implement systems changes that will lead to high-value care education and practice.
Objective
Our team of five medical students and a faculty advisor used a Hackathon-model competition based on a case resulting in a root cause analysis for a patient with osteoarthritis given injections in the wrong knee. The Hackathon’s purpose was to implement a model for students to collaboratively generate corrective action plans rooted in the fundamentals of high-value care.
Methods
We utilized a de-identified occurrence of low-value care based on a patient safety event in our own health system. A case vignette was created based on the root cause’s proximate cause, and then adapted with additional details created by our group about the patient’s medical history and plan of care to emphasize examples of value deficit care (inconsistent safety practices, poor communication between clinician and patient, unnecessary imaging, etc.). Students were encouraged to focus on health systems issues, as opposed to clinician’s individual mistakes. Students will present #betterposters with policy recommendations to address the main problem and instances of low-value care in the case. A judge panel of three providers from the departments of orthopedics, hospital medicine, and the college of medicine were selected to evaluate participants’ #betterposters.
Results
Twelve first year students, divided into four teams, registered for the hackathon. Participants will present posters identifying areas of low-value care from the case and integrated high-value practices and propose action plans to address the case’s proximate cause and the low-value care the patient experienced. Student presentations will include a focused definition of the problem, in-depth analysis of potential causes, identification of low-value care, recognition of stakeholders, determination of measures of success, and plans for implementation of criteria. A post-Hackathon survey including the Maastricht High Value Cost-Conscious Care Attitude Questionnaire (MHAQ) and several original questions will be used to evaluate the curricula’s efficacy in advancing participants’ confidence in identifying low-value care and critically analyzing medical decision-making in the context of high-value care.
Conclusions
A medical student designed and led educational initiative was organized to engage first year medical students in real-world practice identifying and addressing low-value care through a Hackathon competition. A post-Hackathon survey to assess knowledge and attitudes surrounding high-value care is planned.
Clinical Implications
By increasing didactic exposure to the concepts of high-value care, we hope to equip medical students with the skills needed to address instances of low-value care they may encounter while in clerkships to ensure patients they see and providers they work with understand high-value practices.
Please see attached for Literature Cited, and two parts of our post-Hackathon survey, including: the first page of the MHAQ, and our team’s original questions.
