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.

In light of the coronavirus disease 2019 pandemic, we explore the role of stress, fear, and the impact of positive and negative emotions on health and disease. We then introduce strategies to help mitigate stress within the health care team, and provide a rationale for their efficacy. Additionally, we identify strategies to optimize patient care and explain their heightened importance in today’s environment.

If leadership skills can be developed during post-medical school training, physicians will be better prepared to influence positive change for their patients and communities. Based on both LEADS and CanMEDS Leader competencies, a mixed methods approach was used to identify the most valued leadership constructs and which of these should be prioritized for development in an enhanced family medicine curriculum. The interpersonal skills were identified most often and included: selfawareness/leads self, effective communications, leading change and building teams. While some opportunities to achieve competence in leadership skills already exist in family medicine residency programs, increased attention to providing development opportunities as well as assessment methods and faculty development is necessary in order to support new doctors as leaders. This study identifies over-arching goals to guide curriculum change in order to achieve this.

As point of care ultrasound (PoCUS) becomes increasingly popular and a standard of care in many clinical settings, the interest for integration in medical undergraduate curriculum is also growing [1]. This project aims to assess whether formal bedside Focused Abdominal Scan for Trauma (FAST) exam training of medical students increases their knowledge and comfort with the use of bedside ultrasound in a family medicine setting at Queen’s University. Third year medical students (n=18) were recruited to participate in a training session involving a 1-hour online video and 2-hour hands-on session. Knowledge based surveys were completed before and after the training. A survey was completed 4 months after the teaching session evaluating knowledge retention, comfort, and application of skills. Student knowledge of PoCUS and FAST increased and was maintained (pre-training 56%±20%, post-training 82%±10%, p<0.001). Self-evaluation of comfort performing a FAST examination (5-point Likert scale) similarly increased post-training session (pre-training 1.4±0.8, post-training 3.8±0.9, p<0.005), but decreased 4 months later (3±1.2, p<0.005). Students in this study were unanimously interested in ultrasound training and the methods used effectively increased theoretical knowledge and comfort with use. Students did not retain their comfort levels with FAST exam 4 months after the training session, nor did they have the opportunity to utilize the skills learned. Further evidence is required to identify the applicability of these results to undergraduate curriculum development.

Introduction: The literature reveals that residents spend significant amounts of time working with and charting in electronic medical records (EMR). As adoption of EMRs accelerates among emergency medicine (EM) departments, postgraduate programs will need to adapt curricula related to communication in the patient record. In order to make targeted changes, clinician-educators need a better understanding of how the documentation practices of trainees develop and change over residency, as well as the challenges they face in effectively charting. We gathered the perspectives of EM residents on data entry in the EMR to identify opportunities for such change. Methods: We recruited residents from all five years of the Royal College EM residency program at Queen's University and conducted focus groups from August to October 2018. Data collection was audio recorded and later transcribed. Line-by-line coding was performed independently by both AR and NP. A final codebook was validated by ZH. The codebook was then thematically analyzed to identify and characterize themes from the data. The study was approved by the Queen's University Health Sciences Research Ethics Board. Results: 15 EM residents participated. Groups discussed similar challenges with charting, including time constraints, ensuring sufficient, but appropriate detail, variable preceptor expectations, and an inability to draw diagrams. All residents noted formal teaching of the SOAP note framework during medical school and reported receiving an introductory EMR session. Groups highlighted the importance of feedback, especially from physicians with medicolegal experience. They also described more informal learning strategies, including receiving tips from preceptors during shifts and reading the notes of others. They also reported that changes in their documentation practices as junior and senior residents were largely due to a graduation of responsibility and medicolegal considerations. Conclusion: Our results suggest there is a lack of formal postgraduate training for EM residents with respect to documentation in the EMR with reliance on informal teaching and feedback. Future work should explore opportunities to address this gap with various educational strategies, including the development of specific objectives, application of consistent expectations, modelling of excellent chart notes in teaching, and instruction by preceptors with medicolegal experience.