Abstract
This article was migrated. The article was not marked as recommended. Background: Medical education has long recognized the importance of competence in high value care (HVC) but only recently have these concepts been codified. Comprehensive HVC curricula in surgery have not been reported and little is known about graduates' perceptions of HVC education. Our objective was to investigate the perceptions of surgery residency graduates regarding education in HVC and its importance in clinical practice. Methods: Our General Surgery graduates (2012-2016, n=23) were surveyed regarding perceptions of HVC education they received during training and the importance of HVC in their current practice. Results:Thirteen of the 23 graduates responded (57%). While only half of respondents reported receiving instruction in HVC during residency, all reported participating in quality improvement (QI) projects. A minority (n=5, 38%) felt that they had adequate knowledge and skills to lead a QI effort in practice. The majority, however, agreed that knowledge and practical skills in HVC are important to their clinical practice (92%, 77% respectively). Conclusion: General surgery graduates value knowledge in HVC concepts in their current practice, however, most do not feel they possess the knowledge and skills to lead QI efforts. Given that QI work is valued in practice, our results suggest a need to improve HVC education in residency.
Highlights
The United States (US) healthcare system is inefficient, providing care that is of variable quality at high costs (Bentley et al, 2008)
quality improvement (QI) is the component of high value care (HVC) that has been a primary focus of graduate medical education (GME) in surgery, as evidenced by the formation of the American College of Surgeons (ACS), Quality in Training Initiative (QITI), a "multidisciplinary collaborative of academic affiliates of the ACS National Surgical Quality Improvement Program (NSQIP)," which aims to develop a common surgical QI curriculum (Kelz et al, 2013)
Recent general surgery residency graduates value knowledge in HVC concepts in their current practice, many did not have a positive experience with QI projects while in training and even fewer expressed interest in leading QI efforts
Summary
The United States (US) healthcare system is inefficient, providing care that is of variable quality at high costs (Bentley et al, 2008). Since that time, accrediting bodies in medical education have recognized the importance of physician competency in high value care (HVC) concepts, including quality, safety, service, and cost-containment. The Accreditation Council for Graduate Medical Education (ACGME) Core Competencies, introduced in 2002, include systems-based practice (SBP) and practice-based learning and improvement (PBLI), which encompass systems of healthcare delivery, personal practice improvement and quality improvement(Accreditation Council for Graduate Medical Education, 2002) These competencies for graduate medical education (GME) had been in place for a decade, in 2012 the American Hospital Association (AHA) identified significant gaps between physicians’ demonstration of these competencies and their relative importance to healthcare organizations (Combes and Arespacochaga, 2012). Our objective was to investigate the perceptions of surgery residency graduates regarding education in HVC and its importance in clinical practice
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