Capsule Commentary on Tartaglia et al., Medical Student Perceptions of Cost-Conscious Care in an Internal Medicine Clerkship: A Thematic Analysis

Excerpt

This analysis by Tartaglia et al. [1] qualitatively examined medical student reflections on cost-conscious care as part of an integrated high-value care curriculum during the third-year internal medicine clerkship at the Ohio State University College of Medicine. The curriculum consisted of an online high-value care educational module and a reflective exercise in which students were asked to describe a case from their clerkship that lacked “attention to high-value care,” identify a solution, and discuss potential barriers to the success of the solution. Following student completion of the exercise at a 72 % participation rate, responses were coded and analyzed for themes. The most commonly identified contributors to low-value care included unnecessary or duplicative tests and treatments. Proposed solutions focused on processes such as discussion with the team and on interventions such as more appropriate lab testing. Barriers included time/effort, ingrained practices, and defensive medicine. The majority of respondents reported that an attending physician addressed cost versus benefit with the team. …