Spickard Anderson, Gigante Joseph, Stein Glenn, Denny Joshua C
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
J Gen Intern Med. 2008 Jul;23(7):979-84. doi: 10.1007/s11606-008-0608-y.
To determine whether the integration of an automated electronic clinical portfolio into clinical clerkships can improve the quality of feedback given to students on their patient write-ups and the quality of students' write-ups.
The authors conducted a single-blinded, randomized controlled study of an electronic clinical portfolio that automatically collects all students' clinical notes and notifies their teachers (attending and resident physicians) via e-mail. Third-year medical students were randomized to use the electronic portfolio or traditional paper means. Teachers in the portfolio group provided feedback directly on the student's write-up using a web-based application. Teachers in the control group provided feedback directly on the student's write-up by writing in the margins of the paper. Outcomes were teacher and student assessment of the frequency and quality of feedback on write-ups, expert assessment of the quality of student write-ups at the end of the clerkship, and participant assessment of the value of the electronic portfolio system.
Teachers reported giving more frequent and detailed feedback using the portfolio system (p = 0.01). Seventy percent of students who used the portfolio system, versus 39% of students in the control group (p = 0.001), reported receiving feedback on more than half of their write-ups. Write-ups of portfolio students were rated of similar quality to write-ups of control students. Teachers and students agreed that the system was a valuable teaching tool and easy to use.
An electronic clinical portfolio that automatically collects students' clinical notes is associated with improved teacher feedback on write-ups and similar quality of write-ups.
确定将自动化电子临床档案袋整合到临床实习中是否能提高教师针对学生病历书写所提供反馈的质量以及学生病历书写的质量。
作者对一种电子临床档案袋进行了单盲随机对照研究,该档案袋能自动收集所有学生的临床记录,并通过电子邮件通知他们的教师(主治医生和住院医生)。三年级医学生被随机分为使用电子档案袋组或传统纸质方式组。档案袋组的教师使用基于网络的应用程序直接在学生的病历书写上提供反馈。对照组的教师通过在纸质病历的空白处书写直接提供反馈。结果包括教师和学生对病历书写反馈的频率和质量的评估、在实习结束时专家对学生病历书写质量的评估以及参与者对电子档案袋系统价值的评估。
教师报告称使用档案袋系统提供了更频繁、更详细的反馈(p = 0.01)。使用档案袋系统的学生中有70%报告称其超过一半的病历书写收到了反馈,而对照组这一比例为39%(p = 0.001)。使用档案袋的学生的病历书写质量与对照组学生的病历书写质量评级相似。教师和学生都认为该系统是一种有价值的教学工具且易于使用。
自动收集学生临床记录的电子临床档案袋与教师对病历书写的反馈改善以及相似的病历书写质量相关。