Electronic Health Record Training in Undergraduate Medical Education

Wald, Hedy S.; George, Paul; Reis, Shmuel; Taylor, Julie

doi:10.1097/acm.0000000000000131

Cited by 71 publications

(32 citation statements)

References 57 publications

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“…In 2012, the Alliance for Clinical Education recommended medical schools develop clear sets of EHR-competencies and formally train students on these skills to prepare them for clinical practice [12]. The American Medical Association also recommends teaching physicians EHR-related communication skills, and recent editorials have called for curricula to teach these skills [13–16]. …”

Section: Introductionmentioning

confidence: 99%

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Lee

Alkureishi

Wroblewski

et al. 2017

Medical Education Online

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Background: Integrating electronic health records (EHRs) into clinical care can prevent physicians from focusing on patients. Despite rapid EHR adoption, few curricula teach communication skills and best practices for patient-centered EHR use. Objective: We piloted a ‘Patient-centered EHR use’ curriculum, consisting of a lecture and group-observed structured clinical examination (GOSCE) for second-year students (MS2s). Design: During the lecture, students watched a trigger tape video, engaged in a reflective observation exercise, and learned best practices. During the GOSCE, one of four MS2s interacted with a standardized patient (SP) while using the EHR. Third-year students (MS3s) received no formal training and served as a historical control group by completing the same OSCE individually. All students completed post-GOSCE/OSCE surveys. The SP evaluated GOSCE/OSCE performance. Results: In 2013, 89 MS2s participated in the workshop and GOSCEs during their required Clinical Skills course and 96 MS3s participated in individual OSCEs during their end of year multi-station formative GOSCE exercise. Eighty MS2s (90%) and 88 MS3s (92%) post-GOSCE/OSCE surveys were analyzed. Compared to MS3s, significantly more MS2s rated their knowledge (19% vs 55%) and training (14% vs 39%) as good (≥4/5 point scale, P < .001 for both). Most learners (85% MS2s and 70% MS3s) thought training should be required for all students. SP ratings on GOSCE/OSCE performance was higher for the 20 MS2s compared to the 88 MS3 controls (73.5 [SD = 4.5] vs 58.1 [SD = 13.1] on 80 point scale, P < .001). Conclusions: A short workshop and GOSCE were effective in teaching patient-centered EHR use. This curriculum is now a permanent part of our Clinical Skills course. Clerkship students who did not receive our curriculum may have been exposed to negative role-modeling on the wards. To address this, training residents and faculty on patient-centered EHR use skills should be considered. Abbreviations: EHR: Electronic health record; EHR: Electronic health record; SP: Standardized patient

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Section: Introductionmentioning

confidence: 99%

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Lee

Alkureishi

Wroblewski

et al. 2017

Medical Education Online

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“…Only some medical schools have incorporated the topic of adequate use of information technology in their curriculum; training programs for these skills, which are of high importance for today’s physicians, are too often lacking [9, 15]. Therefore, exploring the perspective of deans — the academic authorities — regarding the use of EMR by medical students in comparison to the views of the students themselves will add to our understanding of the challenges medical education is currently facing.…”

Section: Introductionmentioning

confidence: 99%

Discrepancies between perceptions of students and deans regarding the consequences of restricting students’ use of electronic medical records on quality of medical education

Solarte

Könings

2017

BMC Med Educ

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BackgroundElectronic medical records (EMR) are more used in university hospitals, but the use of EMR by medical students at the workplace is still a challenge, because the conflict of interest between medical accountability for hospitals and quality of medical education programs for students. Therefore, this study investigates the use of EMR from the perspective of medical school deans and students, and determines their perceptions and concerns about consequences of restricted use of EMR by students on quality of education and patient care.MethodsWe administered a large-scale survey about the existence of EMR, existing policies, students’ use for learning, and consequences on patient care to 42 deans and 789 Residency Physician Applicants in a private university in Colombia. Data from 26 deans and 442 former graduated students were compared with independent t tests and chi square tests.ResultsOnly half of medical schools had learning programs and policies about the use of EMR by students. Deans did not realize that students have less access to EMR than to paper-based MR. Perceptions of non-curricular learning opportunities how to write in (E)MR were significantly different between deans and students. Limiting students use of EMR has negative consequences on medical education, according to both deans and students, while deans worried significantly more about impact on patient care than students. Billing issues and liability aspects were their major concerns.ConclusionsThere is a need for a clear policy and educational program on the use of EMR by students. Discrepancies between the planned curriculum by deans and the real clinical learning environment as experienced by students indicate suboptimal learning opportunities for students. Creating powerful workplace-learning experiences and resolving concerns on students use of EMR has to be resolved in a constructive collaboration way between the involved stakeholders, including also EMR designers and hospital administrators. We recommend intense supervision of students’ work in EMR to take full advantage of the technological advances of EMR at the modern clinical site, both for patient care and for medical education.

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“…Educational training programs struggle with efforts to incorporate use of operable EMRs in their curricula (Milano, Hardman, Plesiu, Rdesinski, & Biagioli, 2014;Wald, George, Reis, & Taylor, 2014). Student documentation in an actual patient EMR raises concerns related to patient safety, liability and accurate billing and reimbursement (Mintz, Narvarte, O'Brien, Papp, Thomas, & Durining, 2009).…”

Section: Filling the Gapsmentioning

confidence: 99%

“…Student documentation in an actual patient EMR raises concerns related to patient safety, liability and accurate billing and reimbursement (Mintz, Narvarte, O'Brien, Papp, Thomas, & Durining, 2009). As an alternative, an academic EMR (AEMR), which has similar functionality as the EMR (Johnson & Bushey, 2011) can be used as a tool in the educational setting to introduce students to this technology while also fostering student development of core professional competencies (Barnett, 2013;Wald et al, 2014). Health informatics (Borycki et al, 2013), effective communication (Bowers et al, 2011;Morrow et al, 2009) clinical documentation (Stephens, Gimbel, & Pangaro, 2011) and disease prevention and management (Milano et al, 2014) can all be addressed with an AEMR, however barriers exist with implementation of an AEMR as well.…”

Section: Filling the Gapsmentioning

confidence: 99%

Information and Communication Technology to Facilitate Learning for Students in the Health Professions: Current Uses, Gaps and Future Directions

Costello

Corcoran

Barnett

et al. 2014

OLJ

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Changes in the U.S. Healthcare System along with the need for institutions of higher education to prepare a work force ready to address the challenges of today and tomorrow have highlighted the need to incorporate technology in its broadest sense as part of the student learning experience. In health professional education, this becomes challenging as programs have traditionally relied on face-to-face instruction along with internship experiences which provide hands on patient care. In addition, learning activities that incorporate higher order critical thinking must be incorporated in order to meet competency based professional expectations as well as expectations in the work place environment. This article will address current technology use in health professional education programs and identify opportunities to incorporate technology to enhance the student learning experiences with emphasis on the critical thinking, communication, and psychomotor skills required of today's health professional graduate.

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Electronic Health Record Training in Undergraduate Medical Education

Cited by 71 publications

References 57 publications

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use

Discrepancies between perceptions of students and deans regarding the consequences of restricting students’ use of electronic medical records on quality of medical education

Information and Communication Technology to Facilitate Learning for Students in the Health Professions: Current Uses, Gaps and Future Directions

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