Sanford Health, 801 N Broadway, Fargo, ND, 58103, USA.
University of North Dakota School of Medicine and Health Sciences, 1301 N Columbia Rd, Grand Forks, ND, 58203, USA.
BMC Med Educ. 2022 Jul 28;22(1):580. doi: 10.1186/s12909-022-03637-8.
Instant messaging applications and texting are useful for educating and communicating with medical students; however, they present patient privacy concerns and do not address the challenge of student inclusion in patient care communication. EMR-integrated secure messaging offers an opportunity to include students on team communication, enhance their medical education, and ensure patient privacy.
Between July 2019 through March 2020, we performed a mixed method study to evaluate use of EPIC® Secure Chat as a means of enhancing student education and team communication. We promoted use of secure messaging in orientation, performed a pre- and post-rotation survey to assess perceptions of Secure Chat effect on communication, and directly reviewed and categorized messages.
Twenty-four 3rd and 4th year students completed the pre-rotation survey, and 22 completed the post-rotation survey. Twelve (50%) students reported the quality of communication with faculty was either good or very good prior to internal medicine rotation, while 20 (91%) reported this post-rotation (p-value 0.001). There was a similar improvement in communication with ancillary staff. Nineteen (86%) students felt that secure messaging improved their communication with faculty. On message review, threads were frequently logistical, but also often included discussions of patient management.
Students viewed Secure Chat as having a favorable effect on their communication with team members and reported communication on internal medicine to be improved compared to prior rotations. Messages included students on important patient care conversations. Secure messaging offers a novel medium to improve team communication, enhance student education, and maintain patient privacy.
即时通讯应用程序和短信对于教育和与医学生沟通非常有用；然而，它们存在患者隐私问题，并且不能解决学生参与患者护理沟通的挑战。EMR 集成的安全消息传递提供了一个机会，可以在团队沟通中包括学生，增强他们的医学教育，并确保患者隐私。
在 2019 年 7 月至 2020 年 3 月期间，我们进行了一项混合方法研究，以评估 EPIC®Secure Chat 作为增强学生教育和团队沟通的手段。我们在入职培训中推广了安全消息传递的使用，进行了旋转前后的调查，以评估 Secure Chat 对沟通的影响，并直接审查和分类消息。
24 名三、四年级学生完成了旋转前调查，22 名学生完成了旋转后调查。12 名（50%）学生报告在接受内科轮转之前与教师的沟通质量要么好要么非常好，而 20 名（91%）学生报告在轮转后沟通质量更好（p 值为 0.001）。与辅助人员的沟通也有类似的改善。19 名（86%）学生认为安全消息传递改善了他们与教师的沟通。在消息审查中，线程通常是后勤性质的，但也经常包括对患者管理的讨论。
学生认为 Secure Chat 对他们与团队成员的沟通有积极影响，并报告与内科的沟通比以前的轮转有所改善。消息包括学生在内的重要患者护理对话。安全消息传递提供了一种新颖的媒介，可以改善团队沟通，增强学生教育，并维护患者隐私。
