(HealthDay News) — The combination of effective transmission of knowledge, facilitation of reflective practice, and a supportive environment can educate physicians to deliver high-value, cost-conscious care, according to a review published in the Journal of the American Medical Association.
Lorette A. Stammen, MD, from Maastricht University in the Netherlands, and colleagues conducted a literature review to understand the circumstances in which the delivery of high-value, cost-conscious care is learned. Seventy-nine studies met the inclusion criteria, of which 14 were randomized clinical trials. Studies focused on practicing physicians (36.7%), resident physicians (6.3%), and medical students (15.2%).
The researchers found that 12 of the 14 randomized clinical trials addressed knowledge transmission, 7 addressed reflective practice, and 1 addressed supportive environment.
In 10 of the trials the intervention was found to be effective. Three factors were found to aid successful learning: effective transmission of knowledge, such as general health economics and prices of health services, evidence-based guidelines, and patient preferences; facilitation of reflective practice, such as feedback and questions relating to decision about laboratory ordering or prescribing; and creation of a supportive environment in which the health care system organization, presence of role models, and a culture of high-value cost-conscious care strengthen the desired goals of training.
“These factors should be considered when educational interventions are being developed,” the researchers wrote.
- Stammen LA, Stalmeijer RE, Paternotte E, et al. Training Physicians to Provide High-Value, Cost-Conscious Care: A Systematic Review. JAMA. 2015;314(22):2384-2400.