Educators are increasingly aware of the importance of preparing students for our new healthcare system and the value of teaching concepts around quality improvement (QI) and patient safety as part of the medical school curriculum. However, few institutions have formalized curricula around QI/safety and health policy/management for students. In addition, a frequent critique of academic hospital non‐teaching services are the decreased teaching opportunities for hospitalist faculty.
To address these issues, we created a 4th year medical student elective entitled “Quality and Safety in the Hospital”, which consisted of rotating on our institution’s non‐teaching Attending Directed Service (ADS) along with didactics and experiences aimed at increasing exposure and improving knowledge around QI, safety, and our healthcare system. The overarching goal of the elective is to prepare students to function at a high level in a changing health care system they will soon be part of.
Students participating in the elective are assigned to the ADS, and their primary responsibility is to optimize quality and safety on the service. Up to three students work directly with an attending hospitalist on issues such as medication reconciliation, prophylaxis, and transitions in care. Students also participate in a series of workshops and multi‐disciplinary hospital meetings around topics in QI, safety, financial drivers in medicine, health policy and reform (tables 1 and 2). The capstone of the elective is the development of a unique quality or safety improvement project; this allows the students to apply their new knowledge and skills towards improving an aspect of care at our medical center.
Thus far, the elective has garnered positive reviews from students and enrollment has exceeded expectations. The fall 2013 session of the course filled to maximum capacity, and there is a wait list currently for the spring 2014 session. From the fall session, 100% of survey respondents (2/3 students) were “extremely satisfied” with their experience and noted “improved knowledge in policy, QI and safety”. Attendings on ADS also reacted favorably to the elective, with 100% of survey respondents (3/5) in agreement that having the students on service created an academic environment and afforded opportunities to teach; 66% found having the students on a busy service “very useful”. As our health care system continues to rapidly change into a system based on value, students must receive training to prepare them to function at a high level in this new system. Academic hospitalists, with an interest in teaching and expertise in providing high value care for their institutions, are an obvious choice to lead this effort. Our elective is a prototype on how to provide a strong health policy, management, and QI/safety educational experience on a nonteaching service, to the benefit of both students and faculty.
To cite this abstract:Dutta S, Wener J, Brugger M, Kim J, Jaffer A. What I Wish I Learned in Medical School: A Novel Elective Focusing on Health Policy, Quality Improvement, Patient Safety, and Value Based Care. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 183. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/what-i-wish-i-learned-in-medical-school-a-novel-elective-focusing-on-health-policy-quality-improvement-patient-safety-and-value-based-care/. Accessed July 23, 2019.