title: SOAP-V: Introducing a method to empower medical students to be change agents in bending the cost curve.
abstract: Medical students must learn how to practice high-value, cost-conscious care. By modifying the traditional SOAP (Subjective-Objective-Assessment-Plan) presentation to include a discussion of value (SOAP-V), we developed a cognitive forcing function designed to promote discussion of high-value, cost-conscious care during patient delivery. The SOAP-V model prompts the student to consider (1) the evidence that supports a test or treatment, (2) the patient's preferences and values, and (3) the financial cost of a test or treatment compared to alternatives. Students report their findings to their teams during patient care rounds. This tool has been successfully used at 3 medical schools. Preliminary results find that students who have been trained in SOAP-V feel more empowered to address the economic healthcare crisis, are more comfortable in initiating discussions about value, and are more likely to consider potential costs to the healthcare system.
authors.affiliation: Department of Medicine, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Eileen M
authors.initials: EM
authors.lastname: Moser
authors.affiliation: Shapiro Institute for Education and Research, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.|Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Grace C
authors.initials: GC
authors.lastname: Huang
authors.affiliation: Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Clifford D
authors.initials: CD
authors.lastname: Packer
authors.affiliation: Department of Medicine, Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania.
authors.forename: Susan
authors.initials: S
authors.lastname: Glod
authors.affiliation: American College of Physicians, Philadelphia, Pennsylvania.
authors.forename: Cynthia D
authors.initials: CD
authors.lastname: Smith
authors.affiliation: American College of Physicians, Philadelphia, Pennsylvania.
authors.forename: Patrick C
authors.initials: PC
authors.lastname: Alguire
authors.affiliation: Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Sara B
authors.initials: SB
authors.lastname: Fazio
mesh_terms: D002983:Clinical Competence; D003363:Cost Control / Q000379:methods*; D003695:Delivery of Health Care / Q000191:economics*; D004504:Education, Medical, Undergraduate; D006801:Humans; D009519:New York City; D009936:Organizational Innovation; D013337:Students, Medical