Students at Eastern Virginia Medical School (EVMS) learn early in their training about the importance of looking beyond the symptoms a patient is presenting in the exam room, the need to work as part of a team and the drive to provide cost-effective care. EVMS’ CareForward curriculum uses virtual families to help students understand, among other things, how family relationships and social contexts influence patient care.
The virtual families represent people of different ages, genders, sexual orientations, ethnicities, races, cultures, belief systems, literacy levels, socioeconomic statuses and geographical locations. The patients also have varying life experiences and situations. These include: different family dynamics; issues related to veteran affairs; financial turbulence within families; health equity/disparity; access to community resources; and complexities of care in specific patient populations.
“Traditional medical education has focused on the disease, disease processes and how to treat it.’ This curriculum grew out of the realization that health outcomes depend more on social factors outside of the clinic than what happens in the clinic,” said Senthil Kumar Rajasekaran, MD, professor and assistant dean for academic affairs at EVMS. The school, located in Norfolk, is a member of the AMA Accelerating Change in Medical Education Consortium.
The virtual community also allows students to learn about shared duty of care using a team-based care model. In the same context, students explore interprofessional practice as a solution to physician burnout. Nearly 90 percent of students who responded to a survey after using the virtual family tool said they agreed or strongly agreed that “exercises with cases drawn from the virtual families was a worthwhile learning experience.”
“Our students enjoy and value this,” Dr. Rajasekaran said. “They realize this is important and they have asked for an increased presence of this aspect of this curriculum.”
While the approach is being used in the undergraduate setting, Dr. Rajasekaran said it is scalable and applicable in graduate and continuing medical education settings as well.
The EVMS project, “Engaging Students in Educational and Practice Transformation: High-Value and Person Centered Care Taught Through Virtual Families,” was recently named one of the four winners of the Costs of Care Creating Value Challenge, a competition to recognize innovative ideas and projects for teaching and implementing high-value health care among collaborative teams of clinicians, educators, quality improvement specialists and health system administrators. The ABIM Foundation, Costs of Care and the Leapfrog Group organized the contest, which received 83 submissions.
Work at two other consortium schools was also recognized as part of the competition. The University of Utah Health Care was one of the four winners for its entry, “Linking Quality and Costs—Team-Based, Physician-Led Care Redesign for Top 50 Medical Conditions Using Value-Driven Outcomes.” The University of Chicago Pritzker School of Medicine received an honorable mention for its entry, “Use of Simulation to Assess Incoming Interns’ Recognition of Opportunities to Choose Wisely.”