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RESULTSBACKGROUND Role of Electronic Medical Records in medical student education not clear; their use may help or hinder the educational process There.

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Presentation on theme: "RESULTSBACKGROUND Role of Electronic Medical Records in medical student education not clear; their use may help or hinder the educational process There."— Presentation transcript:

1 RESULTSBACKGROUND Role of Electronic Medical Records in medical student education not clear; their use may help or hinder the educational process There is no consensus on best practices for both the use of EMRs and how to educate on and with them Fletcher Allen Health Care installed an EMR in 2009, and other College of Medicine partners are in various stages of EMR adoption Preceptor expectations and experiences may limit value of education surrounding EMRs Early instruction on EMR use develops communication skills that do not develop spontaneously By studying experiences so far, it should be possible to develop best practices METHODS To collect student perspectives we utilized a web based survey. It included: 1)Likert-style questions regarding student satisfaction on EMR training and use 2)Information on all EMRs used 3)Qualitative input via open-ended questions DISCUSSION Amount and level of training are just right or could be increased Ease of use is highly variable EMRs are helpful, but have created barriers for a significant minority of students Open-ended responses helped identify other important themes: EMRs improved access to clinical information EMRs improved efficiency and legibility of note writing “They provide easy access to lab results and a more efficient way to write notes. Furthermore, they allow rapid access to the patient’s medical records in many cases, making the life of a medical student that much easier.” Student suggestions for improving the EMR training process -More training from users closer to their level (e.g. upper-level student TAs or residents) -More specific training on note writing and graduated permission to learn order writing -More consistent guidance from faculty—this raises issues of variability in faculty knowledge and attitudes Only one student described EMR as potentially negatively affecting their medical education: “Decision support reduces need for memorization but also reduces need for thinking (so good and bad).” Greatest limitation is low response rate. To validate the results, distributing the survey to more students would help determine whether the results were affected by selection bias. The uneven distribution of self-rated technical proficiency (Table 1) could indicate selection bias. Turning some of the student suggestions into Likert-style questions could resolve the apparent incongruity between the training satisfaction students reported in the quantitative part of the survey and the dissatisfaction expressed in the open-ended questions. CONCLUSIONS While more survey responses would help assure better reliability, we can qualitatively conclude that: In general the EMR system is helpful: Most students surveyed felt like the level and amount of training they received on EMR use was adequate Most students believed that EMRs helped them accomplish their daily tasks However: Only a minority felt that the EMRs were easy to use A slim majority believed they had adequate computer access to the EMR A similarly slim majority believed that EMRs did not get in the way of their clinical education Next steps Refine survey and larger sample Preceptor perspective Suggestions… This survey indicates that there are some feasible improvements that can be made to EMR education: Faculty development Provide EMR instruction in a graduated way where advanced skills (i.e. templates and pulling data from the EMR) are taught after mastering basic skills Improve computer access to EMR by allowing students to use school laptops to connect to EMR system Proactively collect student feedback on the systems in evaluations at end of each rotation We plan to continue this research by interviewing clerkship faculty and performing a qualitative analysis of the themes from these interviews from which we will develop a survey tool to determine the faculty perspective This project was funded by U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA) CharacteristicN=30(24%) Age in years, mean +SD 29 ±5 Gender, % female 47% EMRs used per student, median (range) 3 (1-9) When it comes to technology and computers I am: More knowledgeable and experienced than my peers 63% About average 37% Less knowledgeable 0% Table 2. Student attitudes regarding EMRs Table 1. Student demographics Medical student perspectives regarding Electronic Medical Records Laura Rabideau, George Vana, Ben Ware, Charles Maclean, MD, UVM COM, Burlington, VT 2011 VT SEARCH Scholars Project GOALS QuestionResponse Too muchJust rightToo little The amount of training I received on this EMR was… 4%60%35% Too detailed Just right Too elementary The level of training I received on this EMR was… 4%78%18% EasyNeutralDifficult Once you had access to this EMR system, how easy was it to use? 42%39%19% AgreeNeutralDisagree This EMR helped me accomplish my daily tasks such as looking up results, writing orders, etc. 72%21%7% This EMR created barriers to my clinical education 23%21%56% I had adequate access to a workstation or laptop 54%16%30% The goals of this project are: 1) To assess student perspective regarding the role of the EMR as a barrier or enabler of learning 2) To use these findings to help improve the College of Medicine curriculum involving electronic medical records


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