# High-Value Care Inclusion in the Preclinical and Clinical Years of Medical School: A Narrative Review and Descriptive Experience at a Single Institution

## TL;DR

This paper reviews how high-value care education is being integrated into medical school, focusing on preclinical years and describing initiatives at one institution.

## Contribution

The paper provides a narrative review and describes a single institution's approach to integrating high-value care education into preclinical medical training.

## Key findings

- High-value care education is limited in preclinical medical school curricula.
- Early exposure to high-value care concepts can improve awareness of cost-effective patient care.
- Institutional initiatives, such as selective courses, help bridge the gap in HVC education.

## Abstract

High-value care (HVC) describes patient-centered management by reducing unnecessary practices and decreasing the overutilization of healthcare resources. Cost-effectiveness is a positive byproduct of its implementation. This principle has recently emerged as a key concept in healthcare, with efforts from several institutions being taken to implement HVC into medical school and residency education. HVC education, however, remains limited in medical school curricula, particularly during the preclinical (first and second) years. As a result, students may be less prepared to apply concepts of value-based care (VBC) during clinical rotations and beyond into clinical practice. Although the implementation of HVC curricula for clinical medical students and residents has been well studied, fewer studies address its integration into preclinical education. Our narrative review examines the existing literature on preclinical and clinical HVC education, exploring already-implemented strategies and initiatives. We further describe HVC education initiatives undertaken at our institution, including the implementation of a first-year selective course, as well as other extracurricular opportunities for medical students designed to bridge the gap between evidence-based research and HVC. Early exposure to HVC learning during the preclinical and clinical years of undergraduate medical training has been suggested to increase awareness of value-based diagnostic and treatment practices and encourage a more focused approach to patient care. Programs not limited to, but including the Mayo Clinic’s Science of Health Care Delivery curriculum and Thomas Jefferson University’s pilot incorporating Choosing Wisely principles, have shown positive outcomes in fostering a deeper understanding of VBC. Despite challenges in implementing HVC education within the traditional curricula and ensuring engagement, we posit that early integration of HVC remains essential for preparing future physicians to deliver patient-centered, cost-effective care.