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Request for Applications

Millennium Conference 2013 on
Teaching Value-Added Care

May 8-10, 2013
Babson Executive Conference Center
Babson College
Wellesley, MA


Sponsored by
Carl J. Shapiro Institute for Education and Research
and
Association of American Medical Colleges (AAMC)

We are pleased to announce a call for applications.
Application deadline:  Friday, February 1, 2013 - 5:00 PM (ET)



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I. Request for Applications

The Carl J. Shapiro Institute for Education and Research at Harvard Medical School and Beth Israel Deaconess Medical Center and the Association of American Medical Colleges, in partnership with the American College of Physicians, requests applications from medical schools and affiliated teaching hospitals who wish to participate in Millennium Conference 2013 on Teaching Value-Added Care. The conference will generate strategies for teaching principles of value-added care in undergraduate medical education (UME) and graduate medical education (GME).

There is no topic more timely or relevant to the current political climate than that of cost-effective care, or as we prefer to frame it, "value-added care." The traditional model for training physicians has failed to meaningfully incorporate contemporary principles of resource utilization, harm from diagnostics, and cost considerations into medical education curricula. Risks of excess radiation exposure are underemphasized, and the physical and psychological consequences of false-positive testing are not real to trainees. Even in the clinical environment, where trainees become increasingly aware of healthcare delivery issues, they still operate under false assumptions about reimbursement and determinants of cost. Discomfort with clinical ambiguity drives test ordering, rather than evidence-based, probabilistic thinking. Furthermore, healthcare professionals regularly combat a widespread expectation from patients that expensive tests such as MRIs are bastions of diagnostic certainty, and they may adopt an approach to medicine that is largely reactive to patient demands. Finally, with the passage of the Affordable Care Act, accountable care organizations and global payment systems are on the rise, which require physicians to consider the cost of care on a daily basis. Thus when trainees enter the workforce, they are both unprepared for the economic realities of the healthcare system and unequipped to engage patients in discussions that promote an approach to care that is appropriate, safe, and efficient.

To address these pressing issues, the focus of the Millennium Conference 2013 will be to discuss value-added care and to consider pedagogical strategies for the delivery of curricula to promote these important principles.

II. Background on the Millennium Conference Series

The Carl J. Shapiro Institute for Education and Research at Harvard Medical School and Beth Israel Deaconess Medical Center has sponsored seven working conferences since 2000 to tackle important topics in medical education, ranging from clinical education to simulation to teaching patient safety to critical thinking.

The format of these conferences, which includes a combination of plenary sessions, small inter-institutional working groups, and the development of plans by school teams, has proven particularly effective in addressing topics of national importance and has led to multiple peer-reviewed publications including consensus recommendations, multi-center collaborations, and research.

The conference is a wonderful opportunity for multi-institutional brainstorming and networking. Additionally, the format has allowed leaders within the same institution, who do not normally have an opportunity to strategize about challenges in teaching, to conduct intra-institutional, long-term planning that crosses the continuum of medical education.

Based on the success of the previous Millennium Conferences and the energizing role they have had for the participating medical schools, the Shapiro Institute and the AAMC are excited to host Millennium Conference 2013 in partnership with the ACP and begin the work of determining the best ways to train our future physicians to be judicious and evidence-based in their use of diagnostic tests and therapeutics.

III. Millennium Conference 2013 on Teaching Value-Added Care

Millennium Conference 2013 will involve 6-8 medical schools in the generation of strategies to teach value-added care across UME and GME.

The goals of the conference are:

1. To describe teaching and assessment approaches for integrating principles of value-added care into medical education curricula
2. To devise strategies for combating aspects of the current practice culture that are resistant to change
3. To stimulate local curriculum reform at participating institutions

Topics to be addressed include:

• The effect of the hidden curriculum as it relates to the incentives associated with different reimbursement environments
• The implications of rationing and the ethics of cost considerations in medicine
• Teaching students and residents how to cope with uncertainty and how to communicate effectively to patients about diagnostic ambiguity
• Decision supports necessary to assist learners in implementing value-added care
• Assessing the "competency" of value-added care
• Professional development models for faculty to teach this topic more effectively

IV. Participants

Each participating school will be asked to send a balanced team of four to five individuals to represent their medical school and its affiliated academic medical center. The team should comprise:

• an individual with oversight for undergraduate curriculum (e.g., pre-clinical or clinical curricular dean, chair of curriculum committee)
• an individual with leadership responsibilities in graduate medical education (e.g., designated institutional official, dean or vice president for GME, program director of a core program)
• course director or core clerkship director
• Medical Director of Operations/Network development (clinician with operations experience)

An additional individual in any of the above categories or one with demonstrated expertise in the topic may attend as a fifth member.
V. Selection Criteria and Guidelines for the Letter of Interest

The letter of interest should describe briefly:

• your institution's commitment to curricular innovation
• the status of current efforts at your institution to teach value-added care
• specific challenges faced by your institution in teaching value-added care
• three questions you would like to see addressed at the conference

Selection of participants will be based on the elements above in addition to the quality of the team members (also see note below). Established educational programs in the area of value-added care or cost-effectiveness are desirable but not required.

VI. Application Process

Your complete electronic application (submitted all at once) must include the following elements:

• Completed  application cover sheet 
• Letter of interest (no longer than two pages)
• Letter of support from the Dean of your medical school
• Brief biographical sketches of team members (no more than 1 page for each team member)

All application materials must be submitted in one email no later than 5:00 PM Eastern Time on February 1, 2013

Carol A. Hughes
Operations Manager
Shapiro Institute for Education and Research
617-667-5494
cahughes@bidmc.harvard.edu

TIMELINE
• Request for Applications mailed on November 1, 2012
• Proposals due by February 1, 2013 at 5:00 PM Eastern Time
• Decision letters mailed around March 1, 2013.


VII. Attendance at the Conference

There is a $250 registration fee for each individual attending the conference to defray administrative costs. Lodging and all meals at the Babson Executive Conference Center will be covered by conference hosts. Transportation costs and the individual registration fee are to be paid by the institutions selected to participate.

Note: Participants applying for the Millennium Conference are expected to reserve the dates in their calendars until decision letters are sent. We consider team members' roles and backgrounds of foremost importance during the selection process and in the subsequent assignment of inter-school working groups. Given the invitational nature of the conference, we reserve the right to decline a team's participation after acceptance if an individual from that team is no longer able to attend.