Cost In Medical Education Research Articles

Cost and value in medical education: the role of statistical process control.

Cost and value in medical education: the role of statistical process control.

Cost in Medical Education: The More Things Change, The More Things Stay The Same

Cost in Medical Education: The More Things Change, The More Things Stay The Same

The future of simulation in medical education

The future of simulation in medical education

What steps are necessary to create written or web-based selected-response assessments?

Before we work out what constitutes an assessment’s value for a given cost in medical education, we must first outline the steps necessary to create an assessment, and then assign a cost to each step. In this study we undertook the first phase of this process: we sought to work out all the steps necessary to create written selected-response assessments. First, the lead author created an initial list of potential steps for developing written assessments. This was then distributed to the other three authors. These authors independently added further steps to the list. The lead author incorporated the contributions of these others and created a second draft. This process was repeated until consensus was achieved amongst the study’s authors. Next, the list was shared by means of an online questionnaire with 100 healthcare professionals with experience in medical education. The results of the authors’ and healthcare professionals’ thoughts and feedback on the steps, needed to create written assessment, are outlined below in full. We outlined the steps that are necessary to create written or web-based selected-response assessments.

Cost in medical education: one hundred and twenty years ago.

The first full paper that is dedicated to cost in medical education appears in the BMJ in 1893. This paper "The cost of a medical education" outlines the likely costs associated with undergraduate education at the end of the nineteenth century, and offers guidance to the student on how to make financial planning. Many lessons can be gleaned from the paper about the cost and other aspects of nineteenth century medical education. Cost is viewed almost exclusively from the domain of the male gender. Cost is viewed not just from the perspective of a young man but of a young gentleman. There is a strong implication that medicine is a club and that you have to have money to join the club and then to take part in the club's activities. Cost affects choice of medical school and selection into schools. The paper places great emphasis on the importance of passing exams at their first sitting and progressing through each year in a timely manner-mainly to save costs. The subject of cost is viewed from the perspective of the payer-at this time students and their families. The paper encourages the reader to reflect on what has and has not changed in this field since 1893. Modern medical education is still expensive; its expense deters students; and we have only started to think about how to control costs or how to ensure value. Too much of the cost of medical education continues to burden students and their families.

Economic analysis in medical education: Definition of essential terms

Medical education is expensive. There is a growing interest in the subject of cost and value in medical education. However, in the medical education literature, terms are sometimes used loosely – and so there is a need for basic grounding in the meaning of commonly used and important terms in medical education economics. The purpose of this article is to define some terms that are frequently used in economic analysis in medical education. In this article, terms are described, and the descriptions are followed by a worked example of how the terms might be used in practice. The following terms are described: opportunity cost, total cost of ownership, sensitivity analysis, viewpoint, activity-based costing, efficiency, technical efficiency, allocative efficiency, price and transaction costs.

Cost and value analyses in medical education: common errors to avoid.

Medical education is associated with substantial cost, so there are a growing number of cost analysis research projects in medical education. Superficially at least these projects should be straightforward, but many errors can occur in their execution. This article highlights some errors that commonly occur and explains how to avoid them.

Costs of ignorance studies in medical education

British Journal of Hospital MedicineVol. 75, No. 2 RegularsCosts of ignorance studies in medical educationKieran WalshKieran WalshSearch for more papers by this authorKieran WalshPublished Online:20 Feb 2014https://doi.org/10.12968/hmed.2014.75.2.117AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Buchan J, Campbell J (2013) Challenges posed by the global crisis in the health workforce. BMJ 347: 6201 Crossref, Google ScholarByford S, Torgerson DJ, Raftery J (2000) Cost of illness studies. BMJ 320: 1335 Crossref, Medline, Google ScholarCarruthers I, Philip P (2006) Safety First – A report for patients, clinicians and health-care managers. http://webarchive.nationalarchives.gov.uk/20130107105354/http:/www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_064159.pdf (accessed 6 January 2014) Google ScholarCrea KA (2011) Practice skill development through the use of human patient simulation. Am J Pharm Educ 75(9): 188 Crossref, Medline, Google ScholarDepartment of Health (2000) An Organisation with a Memory. The Stationery Office, London Google ScholarGordon M, Bose-Haider B (2012) A novel system of prescribing feedback to reduce errors: A pilot study. Int J Risk Saf Med 24(4): 207–14 Medline, Google ScholarHernandez MB, McDonald CL, Gofman Y et al. (2010) Physician Familiarity with the Most Common Misdiagnoses: Implications for Clinical Practice and Continuing Medical Education. The Internet Journal of Medical Education 1(2) (http://ispub.com/IJME/1/2/6945 accessed 6 January 2014) Google ScholarNational Research Council (2007) Preventing Medication Errors: Quality Chasm Series. The National Academies Press, Washington, DC Google ScholarVan Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J (2011) The $17.1 Billion Problem: The Annual Cost Of Measurable Medical Errors. Health Aff 30(4): 596–603 Crossref, Google ScholarWalsh K (2010) Cost effectiveness in medical education. Radcliffe, Oxon Google ScholarWalsh K (2013) Cost and value in medical education. In: Walsh K, ed. The Oxford Textbook of Medical Education. Oxford University Press, Oxford: 601–12 Crossref, Google ScholarWeingart SN, Wilson RM, Gibberd RW, Harrison B (2000) Epidemiology of medical error. BMJ 320(7237): 774–7 Crossref, Medline, Google ScholarWu AW, Folkman S, McPhee SJ, Lo B (1991) Do house officers learn from their mistakes? JAMA 265(16): 2089–94 Crossref, Medline, Google Scholar FiguresReferencesRelatedDetails 2 February 2014Volume 75Issue 2ISSN (print): 1750-8460ISSN (online): 1759-7390 Metrics History Published online 20 February 2014 Published in print 2 February 2014 Information© MA Healthcare LimitedPDF download

Cost and value in medical education--what we can learn from the past.

What lessons can be learned from the history of cost and value in medical education? First, the issue of cost and value in medical education has been around for a long time. Rising costs and an economic recession have made us focus on the subject more, but the issue has been just below the surface for over 200 years. A problem like this will not go away by itself - we must tackle it now. Second, the history of cost and value in medical education makes us look critically at who should pay. Should it be students, institutions or governments? We can see from the past that several different models have been tried; that all have their advantages and disadvantages; and that none are perfect. Third, looking at the past should make us realise that the issue of cost in medical education cannot be viewed in isolation. Medical educators throughout history have looked at how cost can affect selection for medical school, how costs can be related to benefits, and the effect of rising costs on career choices. Cost in medical education has always had far reaching consequences and implications. It probably always will. Looking at issues in medical education from the perspective of cost often makes them more stark and explicit - this in turn may help us to start to find solutions. In the future our solutions must be evidence based and must take account of cost.

Research into cost and value in medical education: can we make findings more generalisable? Commentary.

In recent years a growing number of papers have started to appear in the literature on the subject of cost and value in medical education. However many of the articles describe tactical projects within specific areas. As a result the generalisability of such articles is often questionable. Lack of generalisability will mean that progress in research and practice in this field will be slow. Generalisability of cost-value analyses in any discipline is not always straightforward. However reports on cost and value in medical education should ideally ensure absolute clarity with regard to study centres, enrolment of learners, alternative options, perspectives of stakeholders, resources used and their costs, instruments used, variability, and any problems with the analyses (such as incomplete data).

Cost and value in medical education: the role of discounting.

Cost and value in medical education: the role of discounting.

Medical education, cost and policy: what are the drivers for change? Commentary.

Medical education is expensive. Its expense has led many stakeholders to speculate on how costs could be reduced. In an ideal world such decisions would be made on sound evidence; however this is impossible in the absence of evidence. Sometimes practice will be informed by policy, but policy will not always be evidence based. So how is policy in the field of cost and value in medical education actually developed? The foremost influence on policy in cost and value should be evidence-based knowledge. Unfortunately policy is sometimes influenced by what might at best be termed tradition and at worst inertia. Another influence on policy will be people--but some individuals may have more influence than others. A further influence on policy in this field is events, and mainly events that have gone wrong. One final influence on emerging policy in medical education cost analysis is that of the media.

Cost analyses approaches in medical education: there are no simple solutions

Medical education is expensive. Although we have made progress in working out 'what works' in medical education, there are few data on whether medical education offers value relative to cost. Research into cost and value in medical education is beset by problems. One of the major problems is the lack of clear definitions for many of the terms commonly used. Phrases such as cost-effectiveness analysis, cost-benefit analysis, cost-utility analysis and cost-feasibility analysis are used without authors explaining to readers what they mean (and sometimes without authors themselves understanding what they mean). Sometimes such terms are used interchangeably and sometimes they are used as rhetorical devices without any real evidence that backs up such rhetoric as to the cost-effectiveness or otherwise of educational interventions. The frequent misuse of these terms is surprising considering the importance of the topics under consideration and the need for precision in many aspects of medical education. Here we define commonly used terms in cost analyses and give examples of their usage in the context of medical education. Cost-effectiveness analysis refers to the evaluation of two or more alternative educational approaches or interventions according to their costs and their effects in producing a certain outcome. Cost-benefit analysis refers to 'the evaluation of alternatives according to their costs and benefits when each is measured in monetary terms'. Cost-utility analysis is the examination of two or more alternatives according to their cost and their utility. In this context, utility means the satisfaction among individuals as a result of one or more outcome or the perceived value of the expected outcomes to a particular constituency. Cost-feasibility analysis involves simply measuring the cost of a proposed intervention in order to decide whether it is feasible.

Cost and value in medical education

Cost and value in medical education

Competition and cost in graduate medical education. Should we train unsalaried residents and fellows?

Competition and cost in graduate medical education. Should we train unsalaried residents and fellows?