Design Thinking in Undergraduate Medical Education

To the Editor: There is an overspending problem in U.S. health care. 1 Research has demonstrated that the earlier medical trainees are exposed to cost consciousness, the more lasting it shapes their practices and views. 2 Design thinking in education uses student input to fix what is missing from the learning experience. 3 As Choosing Wisely STARS (Students and Trainees Advocating for Resource Stewardship), participants in a campaign that aims to catalyze grassroots, student-led initiatives to advance health care value in medical education, we leveraged a leadership development program and used design thinking to create extracurricular and curricular interventions that teach evidence-based practices, which prioritize necessary care and avoid medical waste and overuse. Our initiatives as Choosing Wisely STARS have included forming the interest group Healthcare VITALS (Value, Insurance, Transformation, Administration, and Leadership Sciences), which provided an administrative avenue to discuss VITALS’ topics with flexibility and funding. We launched a health care colloquium and invited leaders from within our institution to discuss value from their fields of expertise. We wrote an evidence-based medicine session pairing clinical scenarios with Choosing Wisely recommendations. We included pertinent recommendations in weekly clinical skills guides used by first- and second-year medical students during our clinical immersion program: Medical Student Home (MeSH). We designed ID badges with the principles of high-value care and priming questions for preceptors to generate conversations around these issues for quick reference in the clinical environment. Students, like us, are effective at driving change because we can (1) best identify the unmet need, (2) engage other students by clarifying the why, and (3) force the administration to listen—when students demand change, deans must listen. Becoming student change agents requires creativity to design effective learning experiences, dedication to remain focused through administrative and logistic hurdles, and empowerment to recognize the worth of our contributions. We call on other institutions to create leadership development programs that promote design thinking for curriculum reform. We call on other medical trainees to advance resource-stewardship education so that we can become physician leaders equipped to reduce medical expenditures. Additionally, the authors wish to thank Drs. Rahul Anand, Ilene Rosenberg, and Andrew Selinger for their mentorship

Grassroots · Health care · Medical education · Political science · Psychological intervention · Computer Science · Health Systems, Economic Evaluations, Quality of Life · Healthcare cost, quality, practices · Innovations in Medical Education · Medicine · Nursing · Psychology

• Waste in the US Health Care System

  William H Shrank, Teresa L Rogstad et al.•JAMA•2019

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