融入人文关怀：试点以患者为中心的电子健康记录使用课程。
Incorporating the human touch: piloting a curriculum for patient-centered electronic health record use.
机构信息
a Department of Medicine , University of Chicago , Chicago , IL , USA.
b Department of Pediatrics , University of Chicago , Chicago , IL , USA.
出版信息
Med Educ Online. 2017;22(1):1396171. doi: 10.1080/10872981.2017.1396171.
BACKGROUND
Integrating electronic health records (EHRs) into clinical care can prevent physicians from focusing on patients. Despite rapid EHR adoption, few curricula teach communication skills and best practices for patient-centered EHR use.
OBJECTIVE
We piloted a 'Patient-centered EHR use' curriculum, consisting of a lecture and group-observed structured clinical examination (GOSCE) for second-year students (MS2s).
DESIGN
During the lecture, students watched a trigger tape video, engaged in a reflective observation exercise, and learned best practices. During the GOSCE, one of four MS2s interacted with a standardized patient (SP) while using the EHR. Third-year students (MS3s) received no formal training and served as a historical control group by completing the same OSCE individually. All students completed post-GOSCE/OSCE surveys. The SP evaluated GOSCE/OSCE performance.
RESULTS
In 2013, 89 MS2s participated in the workshop and GOSCEs during their required Clinical Skills course and 96 MS3s participated in individual OSCEs during their end of year multi-station formative GOSCE exercise. Eighty MS2s (90%) and 88 MS3s (92%) post-GOSCE/OSCE surveys were analyzed. Compared to MS3s, significantly more MS2s rated their knowledge (19% vs 55%) and training (14% vs 39%) as good (≥4/5 point scale, P < .001 for both). Most learners (85% MS2s and 70% MS3s) thought training should be required for all students. SP ratings on GOSCE/OSCE performance was higher for the 20 MS2s compared to the 88 MS3 controls (73.5 [SD = 4.5] vs 58.1 [SD = 13.1] on 80 point scale, P < .001).
CONCLUSIONS
A short workshop and GOSCE were effective in teaching patient-centered EHR use. This curriculum is now a permanent part of our Clinical Skills course. Clerkship students who did not receive our curriculum may have been exposed to negative role-modeling on the wards. To address this, training residents and faculty on patient-centered EHR use skills should be considered.
ABBREVIATIONS
EHR: Electronic health record; EHR: Electronic health record; SP: Standardized patient.
背景
将电子健康记录 (EHR) 整合到临床护理中可能会使医生无法专注于患者。尽管 EHR 的采用速度很快，但很少有课程教授沟通技巧和以患者为中心的 EHR 使用的最佳实践。
目的
我们为二年级学生 (MS2) 试点了一门“以患者为中心的 EHR 使用”课程，其中包括讲座和小组观察结构化临床检查 (GOSCE)。
设计
在讲座中，学生观看了一个触发磁带视频，进行了反思观察练习，并学习了最佳实践。在 GOSCE 期间，四名 MS2 中的一名与标准化患者 (SP) 互动，同时使用 EHR。三年级学生 (MS3) 没有接受正式培训，而是通过单独完成相同的 OSCE 作为历史对照组。所有学生都在 GOSCE/OSCE 后完成了调查。SP 评估了 GOSCE/OSCE 的表现。
结果
在 2013 年，89 名 MS2 参加了他们必修的临床技能课程中的讲习班和 GOSCE，96 名 MS3 参加了他们年终多站形成性 GOSCE 练习中的个人 OSCE。对 80 名 MS2(90%)和 88 名 MS3(92%)的 GOSCE/OSCE 后调查进行了分析。与 MS3 相比，显著更多的 MS2 对他们的知识(19%对 55%)和培训(14%对 39%)的评价较好(≥4/5 分制，两者均 P<.001)。大多数学习者(85%的 MS2 和 70%的 MS3)认为所有学生都应该接受培训。与 88 名 MS3 对照组(80 点量表上的 73.5 [SD=4.5]与 58.1 [SD=13.1]，P<.001)相比，SP 在 GOSCE/OSCE 表现上对 20 名 MS2 的评分更高。
结论
一个简短的讲习班和 GOSCE 有效地教授了以患者为中心的 EHR 使用。该课程现在是我们临床技能课程的永久组成部分。没有接受我们课程的实习学生可能在病房里接触到了以患者为中心的 EHR 使用技能的负面榜样。为了解决这个问题，应该考虑对住院医师和教师进行以患者为中心的 EHR 使用技能培训。
缩写
EHR：电子健康记录；EHR：电子健康记录；SP：标准化患者。
Zotero 插件