An electronic medical record in paediatric medical education: - - PowerPoint PPT Presentation

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an electronic medical record in paediatric medical
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An electronic medical record in paediatric medical education: - - PowerPoint PPT Presentation

Nov 13, 2023 379 likes •690 views

An electronic medical record in paediatric medical education: Expectations and experiences of medical students Dr Tom Scodellaro, Dr Wonie Uahwatanasakul, Prof Mike South, Dr Daryl Cheng EMR Project Team, The Royal Childrens Hospital,

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An electronic medical record in paediatric medical education: Expectations and experiences of medical students

Dr Tom Scodellaro, Dr Wonie Uahwatanasakul, Prof Mike South, Dr Daryl Cheng

EMR Project Team, The Royal Children’s Hospital, Melbourne Department of Paediatrics, The University of Melbourne

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Declaration

No conflicts of interest to declare

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A great children’s hospital, leading the way

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First paediatric EMR of its kind in Australia Centralised Integrated Accessible HIMMS Stage 6

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To understand medical students’ expectations and experiences with an EMR system in a hospital setting

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+

Previous Studies

⎯

Undermine learning through inefficiencies

(Hieman et al. 2014)

Compromise patient contact and rapport

(Rouf et al. 2008)

Exclude students from clinical tasks

(Mintz et al. 2009) (Hammoud et al. 2007)

Receive greater feedback

(Rouf et al. 2008)

Benefit from in-built resources

(Keenan et al. 2006)

Medical students are receptive to EMRs

(Tierney et al. 1994)

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+

Previous Studies

⎯

Undermine learning through inefficiencies

(Hieman et al. 2014)

Compromise patient contact and rapport

(Rouf et al. 2008)

Exclude students from clinical tasks

(Mintz et al. 2009) (Hammoud et al. 2007)

Receive greater feedback

(Rouf et al. 2008)

Benefit from in-built resources

(Keenan et al. 2006)

Medical students are receptive to EMRs

(Tierney et al. 1994)

Limitations

Largely North American settings Paternalistic Rarely all-encompassing systems and settings

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Methodology

Formal training

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Methodology

Expectations survey Formal training

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Methodology

Expectations survey Formal training 8 week rotation

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Methodology

Experience survey Expectations survey Formal training 8 week rotation

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Experience & Proficiency Demographics Ease of Use Learning Resources Learning Outcomes Communication

Methodology

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Response Profile

Responses Male Median Age Expectations Survey 94 (87.0%) 51 (54.8%) 24 (IQR 23-26) Experiences Survey 87 (80.5%) 51 (59.3%) Overall 181 (83.8%) 102 (56.4%)

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Majority reported previous experience (63, 67.7%) with non- integrated EMR systems High self-assessed proficiency ∝ Higher perceived ease of use (p<0.001) ∝ Higher perceived ease & depth of learning (p<0.001)

Experience & Proficiency

Cerner Powerchart, 26 Medical Director, 18 Best Practice, 16 DIPS (Norway), 2 PCIS (NT), 1 BOSSnet, 1 APeX (UCSF), 1 Symphony, 1 Genie, 1 Practix, 1
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Met expectations to be easy to learn, use and operate

Ease of Use

Easy to learn and
  • perate
Easy to become skillful Easy to use Expectation 3.862 3.787 3.84 Experience 3.897 3.793 3.851 P-Value 0.56 0.84 0.83 1 2 3 4 5 Mean response score
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Failed to meet expectations to facilitate learning in specific areas Access online information Placing orders Medication interactions

Learning Resources

Access
  • nline
medication information more
  • ften
Learn more about
  • rdering
investigations and medications Learn more about medication interactions Expectation 3.851 3.904 3.851 Experience 3.483 3.402 3.161 Percent Change
  • 9.56%
  • 12.86%
  • 17.90%
P-Value 0.005 0.001 0.001 1 1.5 2 2.5 3 3.5 4 4.5 5
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Marginally improved feedback from clinicians, but not to expected levels (p= 0.02) EMR enabled more robust documentation than students expected (p=0.01)

EMR will improve feedback Enable more complete documentation Expectation 3.505 3.819 Experience 3.172 4.092 Percent Change
  • 9.50%
7.15% P-Value 0.02 0.01 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5

Learning Outcomes

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Students did not expect nor experience the EMR to reduce patient interaction, visual contact or rapport Enhanced students’ ability to contribute to the clinical team

Communication

Spend less time talking to the patient Spend less time looking at the patient Improve
  • verall
rapport with the patient Improve ability to contribute to team Expectation 2.484 2.598 3.14 4.138 Experience 2.69 2.92 3.011 4.198 P-Value 0.2 0.053 0.16 0.31 1 1.5 2 2.5 3 3.5 4 4.5 5
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Key Findings

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Medical students readily engage with the electronic medical record

Key Findings

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Medical students readily engage with the electronic medical record Students recognise several advantages to the EMR in clinical practice

Key Findings

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Medical students readily engage with the electronic medical record Students recognise several advantages to the EMR in clinical practice

Key Findings

Does not impair student- patient communication

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Medical students readily engage with the electronic medical record Students recognise several advantages to the EMR in clinical practice

Key Findings

Integrated resources did not meet expectations Does not impair student- patient communication

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Medical students readily engage with the electronic medical record Students recognise several advantages to the EMR in clinical practice

Key Findings

Integrated resources did not meet expectations Does not impair student- patient communication May not enhance learning or feedback to the degree expected

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Medical students readily engage with the electronic medical record Students recognise several advantages to the EMR in clinical practice

Key Findings

Integrated resources did not meet expectations Does not impair student- patient communication May not enhance learning or feedback to the degree expected

Limitations

Diversity of previous experience Relative measures of experience and expectations Unique, integrated system

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Optimisation

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Creation of a safe-prescribing e-learning module Development of specific templates for student documentation

Optimisation

Created opportunities for students to be involved in the EMR team

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Creation of a safe-prescribing e-learning module Development of specific templates for student documentation

Optimisation

Created opportunities for students to be involved in the EMR team

Future Directions

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Creation of a safe-prescribing e-learning module Development of specific templates for student documentation

Optimisation

Created opportunities for students to be involved in the EMR team

Future Directions

Continue to involve students in EMR Explore ways to use the EMR as an educational tool Further studies to Improve understanding of the EMR-student interaction Investigate how student involvement may benefit clinicians

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www.rch.org.au/emr facebook.com/rchmelbourne @RCHMelbourne tomrscod@gmail.com