Students Lead Change in Academic Medicine
When Chris Moriates, MD, Assistant Dean for Healthcare Value and Associate Professor in the Department of Internal Medicine at Dell Medical School, and colleagues launched the U.S. version of the Choosing Wisely STARS (Students and Trainees Advocating for Resource Stewardship) program in 2017, they speculated that medical students could bring change to their learning that would advance high-value care.
“We hypothesized that students would be able to lead curricular changes in a way that was really effective and this clearly has been shown to be true,” said Moriates, days after the program’s 2020 Leadership Summit. “Now what we’re seeing is that the students are starting to say ‘what more can we do, how can we really further ingrain change.’ ”
On January 11, Choosing Wisely STARS held its third at-capacity conference with pairs of first-year medical students from 50 schools around the country, 100 participants in all, and it was the most diverse representation to date – with 32 returning schools and new participants such as the University of Mississippi, Louisiana State University School of Medicine and the Medical College of Georgia at Augusta.
“What’s remarkable is that when [the program] first started, we had a sense that this model works, that students can actually get in there and lead,” said Moriates, adding that program faculty have been amazed by the students’ outcomes. “More than 60 percent of the schools in the first six months were able to establish some sort of curricular change. People can’t generally do that, especially that quickly.”
The STARS program aims to catalyze grassroots, student-led initiatives to advance health care value in medical education, according to its mission statement. Participants learn about Choosing Wisely principles, leadership and advocacy. Organizers hope the program will lead to a national community of practice for STARS students throughout the United States.
New this year, the program, designed by Costs of Care, asked the representatives from returning schools to meet with their predecessors and designated STARS faculty mentor before attending the summit to review what had been done at their school to date to share with the 2020 leadership class. Faculty sponsors at each school apply to have their students participate, but this year a few students recruited their own faculty sponsors, which helped the program reach schools that had not previously been engaged in Choosing Wisely.
The one-day summit included a Shining STARS panel in which selected students along with faculty members from the 2019 cohort presented their projects to integrate the tenets of Choosing Wisely into their clinical education programs. Students met in 10 small groups where pairs of students from returning schools explained their initiatives, including barriers and facilitators. The students also participated in a rapid crowd-sourcing session to come up with new creative ideas based on what they heard.
“As the summit has matured, we have a lot more experience with what has been done. We were able to really point to the examples of what schools have done,” said Moriates, adding that in the first two years students were coming to Austin without knowing what to expect. “Now they can start with a model in their head about what a Choosing Wisely STARS student does and what the program is. Many have already started that conversation back at home before coming to our summit.”
In one of the closing sessions, “Lead From Where You Stand,” Moriates instructs students in how to apply skills that will help them think through how to influence others to achieve their goals. Last year, Moriates and colleagues published an Academic Medicine article on the global expansion of the STARS model, first launched by Choosing Wisely Canada in 2015.
“Each school has already started to work through how they can advance some of the ideas they heard and we can’t wait to see what they will do this year to advance our shared mission,” he said.
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