Integrating high Value Care Concepts Into a Longitudinal Course for First Year Medical Students

From the 2021 HVPAA National Conference

Haritha Pavuluri (University of South Carolina School of Medicine Greenville), Margaret Oliver, Lauren Demosthenes


As a result of growing concern about healthcare costs for individuals and the country as a whole, many physicians and professional organizations have begun to emphasize the practice of High Value Care (HVC). The American Association of Medical Colleges recommends that students be encouraged to incorporate HVC principles such as cost-effectiveness into their patient plans. Incorporating HVC education into undergraduate medical education is a necessity.


This study aimed to improve foundational knowledge of HVC by incorporating HVC education into the undergraduate medical school curriculum. This serves as an example of integrating HVC education into a pre-existing curriculum.


The first-year class at the University of South Carolina School of Medicine Greenville for the year 2019-2020 was evaluated at the beginning and end of a year-long clinical reasoning course into which HVC concepts were integrated. A pre-education survey was administered to the first-year medical student class, covering several HVC concepts. At the end of the year, a post-education survey was given to the first-year medical student class assessing HVC concepts. Responses between the two surveys were compared to assess acquisition of and confidence in the application of HVC knowledge.


Comparison of responses to pre-education and post-education surveys showed a statistically significant increase in correct or expected answers in 5 of the 8 common questions. 69.8% of students who responded to the survey indicated they agreed that the addition of educational material increased their understanding of HVC and cost of care, while 96.8% of students who responded agreed with the statement that all medical students should have education about the costs of care.


Success in incorporating HVC education into undergraduate medical education can be achieved through meaningful small-scale additions to existing curricula and with faculty involvement. Students overwhelmingly understand the importance of HVC and believe HVC education should be incorporated into medical education. Additional longitudinal curricula can be developed and studied for all years of medical school to assess success and further knowledge and application of HVC concepts.

Clinical Implications

With a robust foundational knowledge of HVC, medical students will be able to better apply HVC in patient care as they move on to learn the clinical practice of medicine, thus decreasing healthcare waste as the next generation of physicians apply these concepts.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

Learn more about HVPA on Health Affairs Blog