[Choosing Wisely concepts should be introduced to medical students at medical schools in Sweden].

Abstract

Choosing Wisely (CW) is an international campaign aiming to reduce low-value care, care without patient benefit. Despite increasing costs in health care, low-value care is a widespread phenomenon. The Swedish Society of Medicine has recently launched CW in Sweden.  Other countries have introduced the concept in medical schools. In the present project, we wanted to investigate whether this could be done in Sweden. We interviewed representatives from medical schools in Canada, Norway, and Sweden, to learn how CW was introduced and integrated in medical education in other countries and to examine the knowledge and attitudes about CW among Swedish medical school faculty, to understand how and if CW could be integrated into the Swedish medical curriculum. We found three ways of implementing CW into a medical curriculum: by letting medical students identify teaching activities, such as case discussions, seminars, and lectures, where CW could be integrated ("bottom-up"), by letting program boards change curricula ("top-down"), or by letting medical students work with specific de-implementation projects as part of their scientific projects ("de-implementation lists").  We also found that faculty at Swedish medical schools are aware of CW to a varying degree, but they agree that reducing low-value care is important and that CW could be implemented already in medical school, perhaps by integrating CW into so-called entrustable professional activities, EPA.