Sebok-Syer Stefanie S, Dukelow Adam M, Sedran Robert, Shepherd Lisa, McConnell Allison, Shaw Jennifer M, Lingard Lorelei
Department of Emergency Medicine Stanford University School of Medicine Palo Alto California USA.
Division of Emergency Medicine at Schulich School of Medicine and Dentistry Western University London Ontario Canada.
AEM Educ Train. 2023 Mar 30;7(2):e10851. doi: 10.1002/aet2.10851. eCollection 2023 Apr.
The electronic health record (EHR) is frequently identified as a source of assessment data regarding residents' clinical performance. To better understand how to harness EHR data for education purposes, the authors developed and authenticated a prototype resident report card. This report card used EHR data exclusively and was authenticated with various stakeholders to understand individuals' reactions to and interpretations of EHR data when presented in this way.
Using principles derived from participatory action research and participatory evaluation, this study brought together residents, faculty, a program director, and medical education researchers ( = 19) to develop and authenticate a prototype report card for residents. From February to September 2019, participants were invited to take part in a semistructured interview that explored their reactions to the prototype and provided insights about how they interpreted the EHR data.
Our results highlighted three themes: data representation, data value, and data literacy. Participants varied in terms of the best way to present the various EHR metrics and felt pertinent contextual information should be included. All participants agreed that the EHR data presented were valuable, but most had concerns about using it for assessment. Finally, participants had difficulties interpreting the data, suggesting that these data could be presented more intuitively and that residents and faculty may require additional training to fully appreciate these EHR data.
This work demonstrated how EHR data could be used to assess residents' clinical performance, but it also identified areas that warrant further consideration, especially pertaining to data representation and subsequent interpretation. Providing residents and faculty with EHR data in a resident report card was viewed as most valuable when used to guide feedback and coaching conversations.
电子健康记录（EHR）常被视为评估住院医师临床表现的数据源。为了更好地理解如何将EHR数据用于教育目的，作者开发并验证了一个住院医师报告卡原型。该报告卡仅使用EHR数据，并与各利益相关者进行了验证，以了解个体在以这种方式呈现EHR数据时的反应和解读。
本研究运用参与式行动研究和参与式评估的原则，召集了住院医师、教员、项目主任和医学教育研究人员（n = 19），共同开发并验证了一个住院医师报告卡原型。2019年2月至9月，邀请参与者参加半结构化访谈，探讨他们对该原型的反应，并提供有关他们如何解读EHR数据的见解。
我们的结果突出了三个主题：数据呈现、数据价值和数据素养。参与者对于呈现各种EHR指标的最佳方式存在差异，并认为应纳入相关的背景信息。所有参与者都认为所呈现的EHR数据很有价值，但大多数人对将其用于评估存在担忧。最后，参与者在解读数据方面存在困难，这表明这些数据可以以更直观的方式呈现，并且住院医师和教员可能需要额外的培训才能充分理解这些EHR数据。
这项工作展示了EHR数据可用于评估住院医师的临床表现，但也确定了需要进一步考虑的领域，特别是与数据呈现和后续解读有关的领域。当用于指导反馈和辅导对话时，在住院医师报告卡中向住院医师和教员提供EHR数据被视为最有价值。
