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越快越好:医学院的高价值医疗教育。

The Sooner the Better: High-Value Care Education in Medical School.

机构信息

A. Erath is a second-year medical student, Medical Ethics, Law and Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee. M. Mitchell is a third-year medical student pursuing a certificate of biomedical ethics, Medical Ethics, Law and Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee, and a masters of health professions education student, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts. S. Salwi is a second-year medical student, Medical Ethics, Law and Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee. Y. Liu is a first-year medical student, Medical Ethics, Law and Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee. A. Sherry is a third-year medical student, Medical Ethics, Law and Policy Student Group, Vanderbilt University School of Medicine, Nashville, Tennessee; ORCID: https://orcid.org/0000-0001-5115-1691.

出版信息

Acad Med. 2019 Nov;94(11):1643-1645. doi: 10.1097/ACM.0000000000002881.

Abstract

Over the last decade in the United States, a national emphasis on controlling health care costs has prompted the medical community to embrace the ideal of high-value care (HVC), with value defined as health outcomes achieved per dollar spent. Despite increasing recognition of its importance as a skill for the modern physician, the practice of HVC remains a relatively new concept. Integrating HVC into medical education has been heterogeneous at best, with the majority of current HVC education thus far implemented at the postgraduate level. The authors present the unique benefits of the earlier introduction of HVC training at the medical school level, including ease of standardization across programs, a synergy in learning the value of an intervention alongside its other innate qualities, and the establishment of a foundational HVC education to allow for specialty-specific value training during residency. In this Invited Commentary, the authors offer practical recommendations for the incorporation of HVC training into medical schools' curricula, with special attention to correlating specific education strategies with the preclerkship, clerkship, and elective years of medical school.

摘要

在过去的十年中,美国一直强调控制医疗保健成本,这促使医学界接受了高价值医疗保健(HVC)的理念,即每花费一美元所获得的健康结果。尽管越来越认识到它作为现代医生的一项技能的重要性,但 HVC 的实践仍然是一个相对较新的概念。将 HVC 纳入医学教育的情况充其量也是参差不齐的,迄今为止,大多数 HVC 教育都是在研究生阶段实施的。作者提出了在医学院层面更早引入 HVC 培训的独特优势,包括在各个项目之间易于实现标准化,在学习干预措施的价值及其其他固有特性的同时实现协同作用,以及建立基础 HVC 教育,以便在住院医师阶段进行特定专业的价值培训。在这篇特邀评论中,作者提出了将 HVC 培训纳入医学院课程的实用建议,特别关注将特定的教育策略与医学院预科、实习和选修阶段相关联。

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