By Maggie Carey, B.Sc.
The preclinical years of medical school are often described as a time when trainees must learn “how to drink from a fire hose.” The volume of information that we are required to learn in fewer than two short years is nothing less than astounding – and we are consistently tested on our knowledge of anatomy, pathophysiology, pharmacology, and more. Clinical skills are introduced, communication skills are emphasized, and simulations abound. Students relish the “real-life clinical examples” that attending physicians share in order to provide greater context to the basic science concepts being presented, but such examples are often de-emphasized in order to provide more time in the curriculum to cover material that we are likely to encounter on board exams.
As a newly minted member of the STARS (Students & Trainees Advocating for Resource Stewardship) program this year, I was faced with a challenge: to raise awareness of high-value care and Choosing Wisely recommendations among medical students. With so many other obligations and facts to learn, I was determined, along with my STARS mentor, Dr. Allen Repp, to find a way to introduce these topics in a way that would engage students without the added content feeling like an academic burden.
I started with a simple idea – to share a single Choosing Wisely recommendation with my classmates each week. I had initially planned to integrate these weekly clinical tips into our course calendar, but found it to be a less feasible option than anticipated. Upon further reflection, I also recognized that it would lack a dynamic aspect to sharing the material. With the large number of items posted on our calendars, it would be too easy to miss the recommendation or simply ignore what appeared to be extraneous material unrelated to current course content. I needed to develop a method that would encourage students to engage with the recommendations in a quick, informative, and enjoyable way.
And thus the Choosing Wisely Prize Raffle was born. As the STARS representative for the University of Vermont’s Larner College of Medicine, I started a post in our “Weekly Wire” student newsletter, which is emailed to all medical students on Sunday mornings. The Weekly Wire contains information pertinent to each class, as well as updates regarding important deadlines and events on campus, so it is widely read by students. Each week, I include a Choosing Wisely recommendation and a link to a clinical vignette-style question based on the recommendation. Correctly answering the multiple-choice question gives students one entry into a prize raffle, and a new winner is drawn every week. The prizes range from UVM bumper stickers to Starbucks gift cards.
The weekly Choosing Wisely prize raffle has now been available to students for 15 weeks and has garnered the participation of student members from every class year. To date, the questions have received over 300 responses, with a correct response rate of 96.4%, which suggests that students take the time to read and consider the recommendations that are presented in the Weekly Wire. The average time spent answering each question is no more than 30 seconds, which minimizes the time and content burden for busy medical students. Students also wait with anticipation for the results of the weekly drawing and receive their prizes with excitement.
Finding a way to teach high-value care to medical students can be difficult, but it is far from impossible. With a bit of creative thinking, a strong student-mentor STARS team, and a few small prizes, medical students can be encouraged to take 30 seconds out of their busy week to appreciate the importance of the Choosing Wisely campaign and learn about the most current clinical practice guidelines.
Carey is a second-year medical student at the University of Vermont’s Larner College of Medicine.