An Electronic Medical Record in Pediatric Medical Education: Survey of Medical Students' Expectations and Experiences

Abstract

Objective This study sought to quantitatively characterize medical students' expectations and experiences of an electronic health record (EHR) system in a hospital setting, and to examine perceived and actual impacts on learning. Methods Medical students from July to December 2016 at a tertiary pediatric institution completed pre- and postrotation surveys evaluating their expectations and experience of using an EHR during a pediatric medicine rotation. Survey data included past technology experience, EHR accessibility, use of learning resources, and effect on learning outcomes and patient–clinician communication. Results Students generally reported high computer self-efficacy (4.16 ± 0.752, mean ± standard deviation), were comfortable with learning new software (4.08 ± 0.771), and expected the EHR to enhance their overall learning (4.074 ± 0.722). Students anticipated the EHR to be easy to learn, use, and operate, which was consistent with their experience (pre 3.86 vs. post 3.90, p = 0.56). Students did not expect nor experience that the EHR reduced their interaction, visual contact, or ability to build rapport with patients. The EHR did not meet expectations to facilitate learning around medication prescribing, placing orders, and utilizing online resources. Students found that the EHR marginally improved feedback surrounding clinical contributions to patient care from clinicians, although not to the expected levels (pre 3.50 vs. post 3.17, p < 0.01). Conclusion Medical students readily engaged with the EHR, recognized several advantages in clinical practice, and did not consider their ability to interact with patients was impaired. There was widespread consensus that the EHR enhanced their learning and clinician's feedback, but not to the degree they had expected.

Improved Medical Student Engagement with EHR Documentation following the 2018 Centers for Medicare and Medicaid Billing Changes

“…Additionally, in Australia, where billing and documentation requirements differ dramatically from the United States, surveyed medical students have readily engaged with the EHR and found it enhanced their learning and the clinical feedback they received. 10,11 These finding are in line with key tenets of experiential learning in adult learning theory. 12 Newer pedagogic models have also suggested enhanced value of authentic activity and assessment in fostering meaningful learning, 13 which may also support enhanced experiential learning when the learner engages in activities that have an audience outside the constructed educational environment (other health care providers and CMS in this case).…”

Medical students’ experience with accessing medical records in Saudi Arabia: a descriptive study

“…The actual usage of EHRs was not measured. However, several studies have used surveys as a tool to understand medical students’ experience with using medical records and their impact on education [ 18 , 20 , 42 ]. Future research may depend on actual user data that can be extracted from EHR systems and reflect actual usage.…”

Scribes, EHRs, and Workflow Efficiencies in Allergy Practices

“…In one study, researchers quantitatively characterized medical students' expectations of an EHR system in a hospital setting and impact on learning. Results showed that medical students recognized clinical advantages, did not consider their ability to interact with patients impaired, and thought EHR marginally improved feedback from clinicians [18].…”