Health care policy is currently under scrutiny due to health care reform, yet in our experience the majority of house staff have insufficient opportunity to learn about the environment they will soon be practicing medicine in. The ACGME attempts to address this through the Systems-based practice competency, but further guidance is lacking.
Our faculty designed a novel curriculum for the 132 Internal Medicine residents in our program entitled “Health Care Reform Week.” The aim was to fill in gaps in resident knowledge and spark new enthusiasm for the topic of health care reform through engaging residents in an educational program spanning one week.
We designed a curriculum introducing house staff to health care reform, and delivered it during daily didactics and Grand Rounds. The schedule contained a mix of pedagogies including lectures and workshops, which culminated in a debate. The first day educated residents on relevant vocabulary, terms and concepts. The second day, an associate program director lectured about the influence of research on policy. The third day covered ACP High Value Cost Conscious Care. For Grand Rounds, chief residents presented their elective drafting bills at New York ACP. On the last day, eight residents utilized a script they wrote themselves to debate the pros and cons of bundled care payments, moderated by the Program Director.
An 11 question survey was distributed at the end of the week. Residents were asked to identify their understanding of relevant material before and after health care reform week using a Likert scale. Of 45 respondents, 23 were PGY1, 9 were PGY2 and 13 were PGY3. Residents endorsed an increase in knowledge post-sessions for all ten fields queried, with the greatest percentage increase noted for bundled care payments. The interest level for health care reform increased from an average score of 2.33 pre sessions to an average score of 4.17 post sessions on a 5 point scale.
Health care reform can be a challenging subject for residents to embrace, but we devised a reproducible one-week curriculum composed of lecture and activities, which our residents felt increased both their knowledge and interest.