High-Value Consults: A Curriculum to Promote Point-of-Care, Evidence-Based Recommendations.
J Grad Med Educ
; 9(5): 640-644, 2017 Oct.
Article
em En
| MEDLINE
| ID: mdl-29075387
ABSTRACT
BACKGROUND:
In an era when value-based care is paramount, teaching trainees to explicitly communicate the evidence behind recommendations fosters high-value care (HVC) in the consultation process.OBJECTIVE:
To implement an HVC consult curriculum highlighting the need for clear consult questions, evidence-based recommendations to improve consult teaching, clinical decision-making, and the educational value of consults.METHODS:
A pilot curriculum was implemented for residents on cardiology consult electives utilizing faculty and fellows as evidence-based medicine (EBM) coaches. The curriculum included an online module, an EBM teaching point template, EBM presentations on rounds, and "coach" feedback on notes.RESULTS:
A total of 15 residents and 4 fellows on cardiology consults participated, and 87% (13 of 15) of residents on consults felt the curriculum was educationally valuable. A total of 80% (72 of 90) of residents on general medicine rotations responded to the survey, and 25 of 72 residents (35%) had a consult with the EBM template. General medicine teams felt the EBM teaching points affected clinical decision-making (48%, 12 of 25) and favored dissemination of the curriculum (90%, 72 of 80). Checklist-guided chart review showed a 22% improvement in evidence-based summaries behind recommendations (7 of 36 precurriculum to 70 of 146 charts postcurriculum, P = .015).CONCLUSIONS:
The HVC consult curriculum during a cardiology elective was perceived by residents to influence clinical decision-making and evidence-based recommendations, and was found to be educationally valuable on both parties in the consult process.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cardiologia
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Sistemas Automatizados de Assistência Junto ao Leito
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Medicina Baseada em Evidências
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Currículo
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Educação de Pós-Graduação em Medicina
Tipo de estudo:
Evaluation_studies
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Guideline
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Prognostic_studies
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Qualitative_research
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article