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The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction

INTRODUCTION: The ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed...

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Autores principales: Shen, E., Cristiano, Joseph Anthony, Ellis, Leslie Renee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Association of American Medical Colleges 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597945/
https://www.ncbi.nlm.nih.gov/pubmed/33150200
http://dx.doi.org/10.15766/mep_2374-8265.10998
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author Shen, E.
Cristiano, Joseph Anthony
Ellis, Leslie Renee
author_facet Shen, E.
Cristiano, Joseph Anthony
Ellis, Leslie Renee
author_sort Shen, E.
collection PubMed
description INTRODUCTION: The ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter. METHODS: Of third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data. During an in-person OSCE with a standardized patient (SP), students performed a focused history and physical, using the EHR to verify allergies and medications. Students completed an electronic patient note graded by faculty. SPs evaluated the students on communication and interpersonal skills with specific rubric elements. Faculty graded the students' notes to evaluate their expression of clinical reasoning in the assessment and plan. RESULTS: Training SPs and faculty to assess students on EHR skills was feasible. After implementation of a comprehensive curriculum focused on EHR and DPR, there was a significant difference on EHR-related communication skills (M = 76.4, SD = 17.6) versus (M = 37, SD = 28.9) before curriculum enhancement t (117.9) = −12.4, p <.001. DISCUSSION: The EHR OSCE station provided a standardized method of assessing students' EHR skills during a patient encounter. Challenges still exist in the technological requirements to develop and deliver cases in today's EHR platform.
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spelling pubmed-75979452020-11-03 The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction Shen, E. Cristiano, Joseph Anthony Ellis, Leslie Renee MedEdPORTAL Original Publication INTRODUCTION: The ability to utilize the electronic health record (EHR) without compromising the doctor-patient relationship (DPR) is an essential skill of all physicians and trainees, yet little time is spent on educating or assessing learners on needed techniques. To address this gap, we developed a conventional OSCE station coupled with a simulated patient chart within the Epic program in order to assess our students' skills utilizing the EHR during a patient encounter. METHODS: Of third-year medical students, 119 were given full access to the patient's simulated chart 24 hours in advance of their OSCE to review clinical data. During an in-person OSCE with a standardized patient (SP), students performed a focused history and physical, using the EHR to verify allergies and medications. Students completed an electronic patient note graded by faculty. SPs evaluated the students on communication and interpersonal skills with specific rubric elements. Faculty graded the students' notes to evaluate their expression of clinical reasoning in the assessment and plan. RESULTS: Training SPs and faculty to assess students on EHR skills was feasible. After implementation of a comprehensive curriculum focused on EHR and DPR, there was a significant difference on EHR-related communication skills (M = 76.4, SD = 17.6) versus (M = 37, SD = 28.9) before curriculum enhancement t (117.9) = −12.4, p <.001. DISCUSSION: The EHR OSCE station provided a standardized method of assessing students' EHR skills during a patient encounter. Challenges still exist in the technological requirements to develop and deliver cases in today's EHR platform. Association of American Medical Colleges 2020-10-28 /pmc/articles/PMC7597945/ /pubmed/33150200 http://dx.doi.org/10.15766/mep_2374-8265.10998 Text en © 2020 Shen et al. https://creativecommons.org/licenses/by/4.0/ This is an open-access publication distributed under the terms of the Creative Commons Attribution (https://creativecommons.org/licenses/by/4.0/) license.
spellingShingle Original Publication
Shen, E.
Cristiano, Joseph Anthony
Ellis, Leslie Renee
The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title_full The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title_fullStr The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title_full_unstemmed The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title_short The Electronic Health Record Objective Structured Clinical Examination Station: Assessing Student Competency in Patient Notes and Patient Interaction
title_sort electronic health record objective structured clinical examination station: assessing student competency in patient notes and patient interaction
topic Original Publication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7597945/
https://www.ncbi.nlm.nih.gov/pubmed/33150200
http://dx.doi.org/10.15766/mep_2374-8265.10998
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