Choosing Wisely: Resource Stewardship Education in Canadian Medical Schools

Abstract Resource stewardship has important implications in terms of healthcare costs as well as patient safety. Currently, there is limited formal teaching in the undergraduate curriculum in Canadian medical schools that addresses this topic. Recently, Choosing Wisely Canada has launched a student campaign to integrate Choosing Wisely concepts into the curriculum, hoping to challenge medical students into thinking about value-based healthcare and patient safety. This article intends to highlight need for resource stewardship education, including associated test costs and its impact on the healthcare system. The strategies currently being implemented at the University of Ottawa will also be discussed.  Résumé L’intendance des ressources a d’importantes répercussions sur les coûts liés aux soins de santé, ainsi que sur la sécurité des patients. À l’heure actuelle, le curriculum de premier cycle des écoles de médecine canadiennes comporte peu d’enseignement formel à ce sujet. Récemment, Choisir avec soin (version francophone de « Choosing Wisely Canada ») a lancé une campagne étudiante pour intégrer les concepts de Choisir avec soin au curriculum, dans l’espoir d’encourager les étudiants en médecine à réfléchir aux soins de santé et à la sécurité des patients fondés sur la valeur. Cet article cherche à souligner l’importance de la formation sur l’intendance des ressources, incluant les coûts associés aux examens et leur impact sur le système de soins de santé. Les stratégies mises en œuvre à l’Université d’Ottawa à l’heure actuelle seront également présentées.

Descriptive Analysis of Patient Experience in Shanghai Primary and Tertiary Care Settings

 Context: China has recently undertaken a nationwide healthcare reform of primary care for its citizens. The new Ottawa-Shanghai Joint School of Medicine (OSJSM) entered this context of reform by developing family medicine training centres for its students. Objective: This study seeks to understand patients’ demographic, perceptions of family medicine, and alignment of needs and values towards family medicine to inform the creation of these new centres. Study Design: To this end, a culturally and linguistically appropriate patient experience survey was created and administered at two primary (CaoJiaDu and TangQiao Community Health Centers) and at a tertiary care centre (Renji Hospital). The survey consisted of questions on demographics, frequency of healthcare usage, satisfaction of care, barriers to access, prioritized values and percep­tions of family medicine. It was administered to 400 patients conveniently sampled to have a balance of primary/tertiary settings. Results: Despite common assumptions that Chinese patients may prefer specialist services, this study revealed a 68.3% preference for General Practitioners (GP) over Specialists. There was also overall agreement and preference for values of continuity, comprehen­siveness, and coordination in healthcare. Conclusion: These findings reveal that primary care is present in Shanghai and that the core values of family medicine are desired by a majority of respondents. Further analysis, qualitative corroboration and repeating the study in a wider population may be re­quired for more generalizable conclusions, as this study in its current design was limited by convenience sampling