High Value Care sub-scores from the Internal Medicine In-Training Examination (IM-ITE) reflect the importance of training medical residents to understand the benefits, harms, and costs of tests and treatments, according to a study published today in Annals of Internal Medicine.

The IM-ITE is a multiple-choice exam developed by the American College of Physicians (ACP) in collaboration with the Alliance for Academic Internal Medicine (AAIM) to help residents along with their program directors assess their knowledge of internal medicine and identify areas for improvement. ACP has a High Value Care initiative, including a curriculum for residents co-developed with AAIM, to help doctors and patients understand the benefits, harms, and costs of tests and treatment options for common clinical issues so they can pursue care together that improves health, avoids harms, and eliminates wasteful practices.

ACP and AAIM identified 38 of 340 questions in the 2012 IM-ITE to create a High Value Care sub-score. The authors found that the HVC sub-scores correlated strongly with overall IM-ITE performance and there was some association between medical resident sub-scores and the care intensity of the training hospital. The most common associated HVC competency was managing conservatively when appropriate (i.e., including allowing adequate time for clinical improvement, observation and monitoring, or comparison to prior studies rather than additional diagnostic testing).

Article: DOI: 10.7326/M14-0444