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Tufts Health Care Institute (THCI) designed an Opinion Survey about topics and issues relevant to the Mini-Rotation. Residents were required to complete the Survey prior to the program; and a slightly modified version was administered two weeks later to assess the program’s impact.

The opinion survey questions included:

  • Rating the U.S. health care system and stating its strengths and weaknesses;
  • Assessing one’s understanding of how health insurance (commercial, Medicare, Medicaid) operates for patients and for physicians;
  • Assigning responsibility for health care outcomes to different stakeholders;
  • Agreeing/disagreeing with public reporting of performance by different institutions and professional groups in the delivery system;
  • Indicating one’s acceptance of performance-based reimbursement;
  • Projecting the impact on health outcomes of several forces for change in today’s health care system; and
  • Agreeing/disagreeing with a series of statements regarding a range of issues in health care and clinical practice.

While individual responses remained confidential, the residents’ aggregated, pre-program responses were shared with the faculty as background for their sessions. Also, THCI staff provided the course co-directors—who helped lead and moderate the actual program—with responses to questions related to each day’s sessions. The course co-directors began each day by sharing these responses with the group as part of the context for that day’s discussions.

The post-program survey responses helped in assessing the Mini-Rotation’s effectiveness. For example:

  • The residents reported higher levels of understanding how different insurance programs operate than they had before the program.
  • They expressed increased awareness for and appreciation of forces beyond the physician’s clinical skills–including health plans’ roles in care management and quality, team-based care, quality measurement, accountable care and health reform.
  • They expressed greater appreciation for the roles of organizations—delivery systems and health plans—in achieving higher quality outcomes along with controlling costs.
  • There was a marked decrease in the number of residents who said they did not know enough about the listed “forces for change” to assess their impact.

Downloadable information and materials regarding the opinion survey