K.B. Born is knowledge translation lead, Choosing Wisely Canada, and assistant professor, Institute of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. C. Moriates is assistant dean for health care value, Department of Medical Education, and associate chair for quality, safety, and value and associate professor of internal medicine, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas, and executive director, Costs of Care, Boston, Massachusetts. V. Valencia is assistant professor, Department of Medical Education, Dell Medical School, University of Texas at Austin, Austin, Texas. M. Kerssens is junior consultant at Adviestalent, part of Twynstra Gudde, Amersfoort, the Netherlands, and was recently a summer research intern with Choosing Wisely Canada, Toronto, Ontario, Canada. B.M. Wong is medical education lead, Choosing Wisely Canada, associate director, Centre for Quality Improvement and Patient Safety, University of Toronto, and associate professor, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Acad Med. 2019 Nov;94(11):1699-1703. doi: 10.1097/ACM.0000000000002868.
Resource stewardship and reducing low-value care have emerged as urgent priorities for health care delivery systems worldwide. However, few medical schools' curricula include adequate content to allow learners to master the knowledge, skills, and attitudes needed to contribute to this transformation toward value-based health care. This article describes a program to launch student-led curriculum enhancement initiatives in 7 countries. The program, called STARS (Students and Trainees Advocating for Resource Stewardship), was inspired by Choosing Wisely, a campaign by the American Board of Internal Medicine Foundation that seeks to promote conversations on avoiding unnecessary medical tests, treatments, and procedures.The initial STARS model, which originated in Canada in 2015, included a leadership summit, where students from multiple medical schools learned about Choosing Wisely principles, leadership, and advocacy. These students then led grassroots efforts at their local medical schools with faculty and other students to raise awareness and advocate for changes related to resource stewardship. Student-led efforts resulted in the integration of Choosing Wisely principles into case-based learning, the creation of student interest groups and electives, the launch of social media campaigns, and the organization of special presentations by local experts.The rapid spread of similar programs in 6 other countries (Italy, Japan, the Netherlands, New Zealand, Norway, and the United States) by 2018 suggests that STARS resonates across multiple settings and signals the potential for such a model to advance other important areas in medical education. This article documents results and lessons learned from the first 4 years of the program.
资源管理和减少低价值的医疗服务已成为全球医疗服务系统的当务之急。然而，很少有医学院的课程包含足够的内容，使学习者能够掌握知识、技能和态度，为向基于价值的医疗保健转变做出贡献。本文描述了一个在 7 个国家启动学生主导的课程强化计划的方案。该计划名为 STARS（学生和受训人员倡导资源管理），它的灵感来自美国内科医师学院基金会的“明智选择”（Choosing Wisely）运动，该运动旨在促进关于避免不必要的医学检查、治疗和程序的对话。最初的 STARS 模式于 2015 年在加拿大启动，包括一个领导力峰会，来自多所医学院的学生在峰会上学习明智选择原则、领导力和倡导。然后，这些学生在当地医学院与教师和其他学生一起，开展基层工作，提高认识并倡导与资源管理相关的变革。学生主导的努力将明智选择原则纳入基于案例的学习，创建学生兴趣小组和选修课程，发起社交媒体活动，并组织当地专家的特别演讲。到 2018 年，这种模式在其他 6 个国家（意大利、日本、荷兰、新西兰、挪威和美国）迅速传播，表明 STARS 在多个环境中产生共鸣，并表明这种模式有可能在医学教育的其他重要领域取得进展。本文记录了该计划头 4 年的成果和经验教训。
