Lokmic-Tomkins Zerina, Gray Kathleen, Cheshire Lisa, Parolini Arno, Sharp Megan, Tarrant Bronwyn, Hill Nicole, Rose David, Webster Marilyn, Virtue Debra, Brignell Amanda, Waring Rebecca, Broussard Fiona, Tsirgialos Alex, Meng Cham Kwang
Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia; Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia.
Centre for Digital Transformation of Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Grattan Str, Parkville, Victoria, Australia.
Int J Med Inform. 2023 Jan;169:104910. doi: 10.1016/j.ijmedinf.2022.104910. Epub 2022 Nov 9.
Electronic medical record (EMR) adoption across healthcare necessitates a purposeful curriculum design to prepare graduates for the delivery of safe and effective patient care in digitally-enabled environments.
To describe the design and development of an Interprofessional Electronic Medical Record (iEMR) subject that introduces healthcare students to its utility in clinical settings.
A six-stage design-based educational research framework (Focus, Formulation, Contextualisation, Definition, Implementation, Evaluation) was used to instigate the iEMR design and development in nursing and five allied health graduate entry to practice (preregistration) degrees at an Australian university.
In the Focus process, the concept and interdisciplinary partnerships were developed. The Formulation process secured grant support for subject design and development, including a rapid literature review to accommodate various course and curriculum structures. Discipline-specific subject themes were created through the Contextualisation process. During the Definition process, learning objectives and content resources were built. The Implementation process describes the pilot implementation in the nursing program, where assessment tasks were refined, and interdisciplinary clinical case studies originated.
The design and development of an iEMR subject is underpinned by internal support for educational innovation and in alignment with digital health strategies in employer organisations. Identified barriers include faculty-level changes in strategic support for teaching innovation, managerial expectations of workload, the scope of work required by academics and learning designers, and the gap between the technology platform required to support online learning and the infrastructure needed to support simulated EMR use. A key discovery was the difficulty of finding EMR software, whether designed for teaching purposes or for clinical use, that could be adapted to meet the needs of this project.
The lessons learned are relevant to educators and learning designers attempting a similar process. Issues remain surrounding the sustainability of the iEMR subject and maintaining academic responsibility for ongoing curriculum management.
在医疗保健领域采用电子病历(EMR)需要有针对性的课程设计,以使毕业生能够在数字化环境中提供安全有效的患者护理。
描述跨专业电子病历(iEMR)课程的设计与开发,该课程向医学生介绍其在临床环境中的应用。
采用基于设计的六阶段教育研究框架(聚焦、制定、情境化、定义、实施、评估),在澳大利亚一所大学的护理专业以及五个联合健康专业的研究生入学实践(预注册)学位课程中推动iEMR的设计与开发。
在聚焦阶段,形成了概念和跨学科合作关系。制定阶段获得了课程设计与开发的资助支持,包括进行快速文献综述以适应各种课程和课程结构。通过情境化阶段创建了特定学科的主题。在定义阶段,确定了学习目标和内容资源。实施阶段描述了护理课程中的试点实施情况,在此过程中完善了评估任务,并产生了跨学科临床案例研究。
iEMR课程的设计与开发得到了对教育创新的内部支持,并与雇主组织的数字健康战略保持一致。已识别的障碍包括教师层面在教学创新战略支持方面的变化、管理层对工作量的期望、学者和学习设计师所需的工作范围,以及支持在线学习所需的技术平台与支持模拟EMR使用所需基础设施之间的差距。一个关键发现是难以找到适用于教学目的或临床使用的EMR软件,且该软件能够适应本项目的需求。
所吸取的经验教训对尝试类似过程的教育工作者和学习设计师具有参考价值。iEMR课程的可持续性以及对课程持续管理的学术责任方面仍存在问题。