Dr. Wald is clinical associate professor of family medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. George is assistant professor of family medicine and director of second-year curriculum, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Reis is chair, faculty development unit, Bar-Ilan University Faculty of Medicine in the Galilee, Safed, Israel and adjunct professor of family medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Dr. Taylor is professor of family medicine and director of clinical curriculum, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Acad Med. 2014 Mar;89(3):380-6. doi: 10.1097/ACM.0000000000000131.
While electronic health record (EHR) use is becoming state-of-the-art, deliberate teaching of health care information technology (HCIT) competencies is not keeping pace with burgeoning use. Medical students require training to become skilled users of HCIT, but formal pedagogy within undergraduate medical education (UME) is sparse. How can medical educators best meet the needs of learners while integrating EHRs into medical education and practice? How can they help learners preserve and foster effective communication skills within the computerized setting? In general, how can UME curricula be devised for skilled use of EHRs to enhance rather than hinder provision of effective, humanistic health care?Within this Perspective, the authors build on recent publications that "set the stage" for next steps: EHR curricula innovation and implementation as concrete embodiments of theoretical underpinnings. They elaborate on previous calls for maximizing benefits and minimizing risks of EHR use with sufficient focus on physician-patient communication skills and for developing core competencies within medical education. The authors describe bridging theory into practice with systematic longitudinal curriculum development for EHR training in UME at their institution, informed by Kern and colleagues' curriculum development framework, narrative medicine, and reflective practice. They consider this innovation within a broader perspective-the overarching goal of empowering undergraduate medical students' patient- and relationship-centered skills while effectively demonstrating HCIT-related skills.
虽然电子健康记录 (EHR) 的使用已经成为一种现代趋势，但医疗保健信息技术 (HCIT) 能力的刻意教学却没有跟上这种快速发展的步伐。医学生需要接受培训才能成为 HCIT 的熟练使用者，但本科医学教育 (UME) 中的正式教学却很少。医学教育者如何在将 EHR 融入医学教育和实践的同时，满足学习者的需求？他们如何帮助学习者在计算机环境中保持和培养有效的沟通技巧？总的来说，如何设计 UME 课程，以熟练使用 EHR 来增强而不是阻碍提供有效、人性化的医疗保健？在这篇观点文章中，作者以最近的出版物为基础，“为下一步奠定了基础”：EHR 课程的创新和实施是理论基础的具体体现。他们详细阐述了之前的呼吁，即充分关注医患沟通技巧，最大限度地发挥 EHR 使用的好处，将风险最小化，并在医学教育中发展核心能力。作者描述了如何将理论应用于实践，即在他们所在机构的 UME 中进行 EHR 培训的系统纵向课程开发，该课程开发框架以 Kern 及其同事的课程开发框架、叙事医学和反思性实践为基础。他们在更广泛的背景下考虑了这一创新——使本科医学学生的以患者和关系为中心的技能以及有效展示 HCIT 相关技能的能力得到增强。
