Evidence map›Paper›PMID 39838252›Full record

ArticleJournal of general internal medicine2025

Medical Students' Observations of High Value and Potentially Wasteful Care Behaviors Modeled During Clinical Rotations.

Amanda Wade, Meher Kalkat, Colin Uyeki, Neha Arora, Jill Stachowski, Eric Gullborg, Nicholas Demetriou, Anuradha Haridhas, Scott Giberson, Anwar Ahmed Khan and 13 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of general internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Amanda WadeOregon Health & Science University School of Medicine, Portland, OR, USA.
Meher KalkatJohns Hopkins School of Medicine, Baltimore, MD, USA.
Colin UyekiFrank H Netter School of Medicine, North Haven, CT, USA.
Neha AroraTexas A&M School of Medicine, Bryan, TX, USA.
Jill StachowskiPenn State College of Medicine, Hershey, PA, USA.
Eric GullborgEastern Virginia Medical School, Norfolk, VA, USA.
Nicholas DemetriouNorthwestern University Feinberg School of Medicine, Chicago, IL, USA.
Anuradha HaridhasWright State University Boonshoft School of Medicine, Dayton, OH, USA.
Scott GibersonUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
Anwar Ahmed KhanFlorida State University College of Medicine, Tallahassee, FL, USA.
Nikita ChoudharyDell Medical School at the University of Texas at Austin, Austin, TX, USA.
Robert MilmanTexas A&M School of Medicine, Bryan, TX, USA.
Kelly LatimerEastern Virginia Medical School, Norfolk, VA, USA.
Brian McGillenPenn State College of Medicine, Hershey, PA, USA.
Amanda BellWright State University Boonshoft School of Medicine, Dayton, OH, USA.
Casey Olm-ShipmanUniversity of North Carolina School of Medicine, Chapel Hill, NC, USA.
Howard SelingerFrank H Netter School of Medicine, North Haven, CT, USA.
Ashwini Niranjan-AzadiJohns Hopkins School of Medicine, Baltimore, MD, USA.
Rishi AgrawalNorthwestern University Feinberg School of Medicine, Chicago, IL, USA.
Jonathan AppelbaumFlorida State University College of Medicine, Tallahassee, FL, USA.
Christopher MoriatesVeterans Administration Greater Los Angeles Healthcare System, Los Angeles, USA.
Patricia A CarneyOregon Health & Science University School of Medicine, Portland, OR, USA.
Andrea SmeraglioOregon Health & Science University School of Medicine, Portland, OR, USA. Smeragli@ohsu.edu.ORCID 0000-0003-0775-7930

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMedical student exposure to role-modeling of high-value care (HVC) behaviors may shape professional identity formation and future HVC practices.

objectiveTo investigate the frequency and characteristics of HVC role-modeling witnessed by medical students during core clinical rotations.

designCross-sectional survey study.

participantsMedical students on clinical rotations at 11 US medical schools. MAIN MEASURES: A validated 13-item survey was used to assess medical student perception of cost-conscious role-modeling behaviors or potentially wasteful role-modeling behaviors and modified to include whom demonstrated the behavior (attending vs resident/fellow) and during which clinical rotation the modeling occurred. KEY

resultsCost-conscious role-modeling behaviors were observed by medical students sometimes/often 52.9-70.5% (353/667-452/641) of the time across all clinical rotations, except for praising a student for ordering a cost-effective diagnostic work-up which was seen only 25.7% (143/556) of the time. Potentially wasteful role-modeling behaviors were observed sometimes/often 5-14.3% (26/537-87/609) of the time, except simultaneously ordering numerous tests before seeing results of initial screening tests 45.1% (273/605) and repeating tests rather than attempting to obtain recently performed test results 32.2% (194/602). HVC modeling was most often demonstrated by internal medicine attendings 67.7% (65/96) and least frequently by general surgery attendings 47.3% (17/36). Attendings were overall more likely to model HVC compared to residents/fellows.

conclusionHVC role-modeling, as observed by medical students, is not consistently demonstrated across clinical rotations. Attendings generally model more HVC than residents and general surgery models less HVC compared to other specialties. Future studies should strive to identify factors which promote or inhibit HVC modeling.

Indexed as

Clinical ClerkshipStudents, MedicalAdultCross-Sectional StudiesFemaleHumansMaleUnited Stateshigh-value carehigh-value cost-conscious careHVCundergraduate medical education

Identifiers

PMID39838252
PMCPMC12119451

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.