{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:34:42Z","timestamp":1790847282208,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Despite increasing healthcare costs, training on cost\u2010consciousness is lacking in graduate medical education (GME). Medical centers must consider how best to incorporate value\u2010based training into their GME curricula.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To incorporate low\u2010value principles into an existing GME simulation exercise and assess incoming interns' recognition of low\u2010value care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      Choosing Wisely\u2122 lists were reviewed to identify 4 low\u2010value hazards to be embedded into a simulated hospital room in addition to the 8 patient safety hazards used previously. Interns were given 10 minutes to independently review a mock chart and list all hazards they identified in the simulation. Interns completed a short survey on their prior training in medical school and a follow\u2010up survey one month into internship.\n                      <jats:italic>T<\/jats:italic>\n                      tests used to compare identification of low\u2010value vs safety hazards and to associate performance with prior training.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The mean percentage of hazards correctly identified was 50.4% (standard deviation [SD] 11.8%). Interns identified significantly fewer low\u2010value hazards (mean 19.2%, SD 18.6%) than safety hazards (mean 66.0%, SD 16.0%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). For example, while 96% of interns identified the hand hygiene hazard, only 6% identified the unnecessary blood transfusion and none identified the unnecessary stress ulcer prophylaxis. Interns who self\u2010reported as confident in their ability to identify hazards were not any more likely to correctly identify hazards than those who were not confident.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The \u201cRoom of Horrors\u201d simulation revealed poor awareness of low\u2010value care among interns. The simulation highlights a promising model for the prioritization and inclusion of value\u2010based experiential training in GME.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12788\/jhm.2761","type":"journal-article","created":{"date-parts":[[2017,7,10]],"date-time":"2017-07-10T12:18:23Z","timestamp":1499689103000},"page":"493-497","source":"Crossref","is-referenced-by-count":15,"title":["Use of Simulation to Assess Incoming Interns' Recognition of Opportunities to Choose Wisely"],"prefix":"10.1002","volume":"12","author":[{"given":"Kathleen M.","family":"Wiest","sequence":"first","affiliation":[{"name":"Pritzker School of Medicine University of Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne M.","family":"Farnan","sequence":"additional","affiliation":[{"name":"Pritzker School of Medicine University of Chicago Chicago Illinois"},{"name":"Section of Hospital Medicine University of Chicago Medical Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Byrne","sequence":"additional","affiliation":[{"name":"Harris School of Public Policy University of Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Matern","sequence":"additional","affiliation":[{"name":"Pritzker School of Medicine University of Chicago Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Cappaert","sequence":"additional","affiliation":[{"name":"University of Chicago Simulation Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Hirsch","sequence":"additional","affiliation":[{"name":"Graduate Medical Education University of Chicago Medical Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet M.","family":"Arora","sequence":"additional","affiliation":[{"name":"Pritzker School of Medicine University of Chicago Chicago Illinois"},{"name":"Section of General Internal Medicine University of Chicago Medical Center Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010014\u20103070\u2010z"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.828"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp0911502"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010155\u20106\u2010201109200\u201000007"},{"key":"e_1_2_5_6_1","volume-title":"Graduate Medical Education That Meets the Nation's Health Needs"},{"key":"e_1_2_5_7_1","unstructured":"Accreditation Council for Graduate Medical Education.CLER Pathways to Excellence.https:\/\/www.acgme.org\/acgmeweb\/Portals\/0\/PDFs\/CLER\/CLER_Brochure.pdf. 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