Given several dynamics involved in determining whether children are healthy or not, which are common worldwide, viewing the literature from a global perspective produces novel insights regarding the tendency of policies and programmes to reduce or, to exacerbate, the effects of socioeconomic disadvantage on child health.

Objective Our objectives were to identify educational interventions designed to equip medical students or residents with knowledge or skills related to various uses of electronic health records (EHRs), summarize and synthesize the results of formal evaluations of these initiatives, and compare the aims of these initiatives with the prescribed EHR-specific competencies for undergraduate and postgraduate medical education. Materials and Methods We conducted a systematic review of the literature following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses) guidelines. We searched for English-language, peer-reviewed studies across 6 databases using a combination of Medical Subject Headings and keywords. We summarized the quantitative and qualitative results of included studies and rated studies according to the Best Evidence in Medical Education system. Results Our search yielded 619 citations, of which 11 studies were included. Seven studies involved medical students, 3 studies involved residents, and 1 study involved both groups. All interventions used a practical component involving entering information into a simulated or prototypical EHR. None of the interventions involved extracting, aggregating, or visualizing clinical data for panels of patients or specific populations. Discussion This review reveals few high-quality initiatives focused on training learners to engage with EHRs for both individual patient care and population health improvement. In comparing these interventions with the broad set of electronic records competencies expected of matriculating physicians, critical gaps in undergraduate and postgraduate medical education remain. Conclusions With the increasing adoption of EHRs and rise of competency-based medical education, educators should address the gaps in the training of future physicians to better prepare them to provide high quality care for their patients and communities.

Background The collection of race, ethnicity, and language (REaL) data from patients is advocated as a first step to identify, monitor, and improve health inequities. As a result, many health care institutions collect patients' preferred languages in their electronic health records (EHRs). These data may be used in clinical care, research, and quality improvement. However, the accuracy of EHR language data are rarely assessed. Objectives This study aimed to audit the accuracy of EHR language data at two academic hospitals in Toronto, Ontario, Canada. Methods The EHR language was compared with a patient's stated preferred language by interview. Language was dichotomized to English or non-English. Agreement between language documented in the EHR and patient-reported preferred language was calculated using sensitivity, specificity, and positive predictive value (PPV). Results A total of 323 patients were interviewed, including 96 with a stated non-English preferred language. The sensitivity of the EHR for English-language preference was high at both hospitals: 100% at hospital A with a PPV of 88%, and 99% at hospital B with a PPV of 85%. However, the sensitivity of the EHR for non-English preference differed greatly between the two hospitals. The sensitivity was 81% with a PPV of 100% at hospital A and the sensitivity was 12% with a PPV of 60% at hospital B. Conclusion The accuracy of the EHR for identifying non-English language preference differed greatly between the hospitals studied. Language data must be accurate for it to be used, and regular quality assurance is required.

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