title: Defining competencies for education in health care value: recommendations from the University of California, San Francisco Center for Healthcare Value Training Initiative.
abstract: Leaders in medical education have increasingly called for the incorporation of cost awareness and health care value into health professions curricula. Emerging efforts have thus far focused on physicians, but foundational competencies need to be defined related to health care value that span all health professions and stages of training. The University of California, San Francisco (UCSF) Center for Healthcare Value launched an initiative in 2012 that engaged a group of educators from all four health professions schools at UCSF: Dentistry, Medicine, Nursing, and Pharmacy. This group created and agreed on a multidisciplinary set of comprehensive competencies related to health care value. The term "competency" was used to describe components within the larger domain of providing high-value care. The group then classified the competencies as beginner, proficient, or expert level through an iterative process and group consensus. The group articulated 21 competencies. The beginner competencies include basic principles of health policy, health care delivery, health costs, and insurance. Proficient competencies include real-world applications of concepts to clinical situations, primarily related to the care of individual patients. The expert competencies focus primarily on systems-level design, advocacy, mentorship, and policy. These competencies aim to identify a standard that may help inform the development of curricula across health professions training. These competencies could be translated into the learning objectives and evaluation methods of resources to teach health care value, and they should be considered in educational settings for health care professionals at all levels of training and across a variety of specialties.
authors.affiliation: Dr. Moriates is assistant clinical professor of medicine, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Dohan is professor of health policy and social medicine, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Spetz is professor of health policy, Philip R. Lee Institute for Health Policy Studies, and associate director for research strategy, Center for the Health Professions, University of California, San Francisco School of Medicine, San Francisco, California. Dr. Sawaya is professor of obstetrics, gynecology and reproductive science, and of epidemiology and biostatistics, University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Christopher
authors.initials: C
authors.lastname: Moriates
authors.forename: Daniel
authors.initials: D
authors.lastname: Dohan
authors.forename: Joanne
authors.initials: J
authors.lastname: Spetz
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
mesh_terms: D002140:California; D003162:Competency-Based Education / Q000379:methods*; D003479:Curriculum; D003695:Delivery of Health Care; D017048:Health Care Costs; D006281:Health Occupations / Q000193:education*; D006291:Health Policy; D007348:Insurance, Health