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在加拿大,采用电子病历站进行客观结构化临床考试以评估医学生沟通技能的经验:一项描述性研究。

Experience of introducing an electronic health records station in an objective structured clinical examination to evaluate medical students’ communication skills in Canada: a descriptive study.

机构信息

Department of Emergency Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

Medical Council of Canada, Ottawa, ON, Canada.

出版信息

J Educ Eval Health Prof. 2023;20:22. doi: 10.3352/jeehp.2023.20.22. Epub 2023 Jul 4.

DOI:10.3352/jeehp.2023.20.22
PMID:37400976
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10442496/
Abstract

PURPOSE

There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study explored the feasibility of an EMR objective structured clinical examination (OSCE) station to evaluate medical students’ communication skills by psychometric analyses and standardized patients’ (SPs) perspectives on EMR use in an OSCE.

METHODS

An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2020. Students’ communication skills were assessed by SPs and physician examiners. Students’ scores were compared between the EMR station and 9 other stations. A psychometric analysis, including item total correlation, was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs’ effect on communication.

RESULTS

Ninety-nine 3rd-year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P=0.041). The thematic analysis of SPs’ perceptions of students’ EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage.

CONCLUSION

This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aid in patient counseling. Teaching students how to be patient-centered even in the presence of technology may promote engagement.

摘要

目的

与电子病历(EMR)相关能力评估相关的文献有限。为了解决这一差距,本研究通过心理测量分析和标准化患者(SP)对 EMR 在 OSCE 中使用的看法,探讨了一种 EMR 客观结构化临床考试(OSCE)站评估医学生沟通技巧的可行性。

方法

开发并于 2020 年 3 月对纳入 EMR 使用的 OSCE 站进行了试点测试。SP 和医师考官评估学生的沟通技巧。将学生在 EMR 站和其他 9 个站的得分进行比较。进行心理测量分析,包括项目总分相关。SP 参加了 OSCE 后的焦点小组讨论,讨论他们对 EMR 对沟通影响的看法。

结果

99 名三年级医学生参加了 10 站 OSCE,其中包括使用 EMR 站。EMR 站的项目总分相关度可接受(0.217)。在咨询中利用图形显示的学生从 SP 那里获得了更高的 OSCE 站分数(P=0.041)。从焦点小组中对 SP 对学生 EMR 使用看法的主题分析得出了以下主题领域:技术、沟通、病例设计、健康信息所有权和 EMR 使用时间。

结论

本研究表明,在 OSCE 中评估学习者沟通技巧时,纳入 EMR 是可行的。EMR 站具有可接受的心理测量特征。一些医学生能够有效地将 EMR 作为患者咨询的辅助工具。即使在存在技术的情况下,教学生如何以患者为中心也可能促进参与。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/dde8882a45af/jeehp-20-22f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/d24c423dbdc5/jeehp-20-22f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/5f85885f7370/jeehp-20-22f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/352a9167fec1/jeehp-20-22f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/dde8882a45af/jeehp-20-22f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/d24c423dbdc5/jeehp-20-22f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/5f85885f7370/jeehp-20-22f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/352a9167fec1/jeehp-20-22f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/193a/10442496/dde8882a45af/jeehp-20-22f4.jpg

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