Medical Education in the Electronic Medical Record (EMR) Era

Abstract

In the last decade, electronic medical record (EMR) use in academic medical centers has increased. Although many have lauded the clinical and operational benefits of EMRs, few have considered the effect these systems have on medical education. The authors review what has been documented about the effect of EMR use on medical learners through the lens of the Accreditation Council for Graduate Medical Education's six core competencies for medical education. They examine acknowledged benefits and educational risks to use of EMRs, consider factors that promote their successful use when implemented in academic environments, and identify areas of future research and optimization of EMRs' role in medical education.

Internal medicine progress note writing attitudes and practices in an electronic health record

“…"Bloated" notes may be less effective as a communication tool. 12 Additionally, the process of composing a note often stimulates critical thinking and may lead to changes in care. The act of copying forward a previous note and autopopulating data bypasses that process and in effect may suppress critical thinking.…”

The effect of provider characteristics on the responses to medication-related decision support alerts

“…Tierney et al [30] reviewed the literature on the effects of using EHR on medical learners, and found strong mistrust and concerns that CDS functions in EHR and CPOE system can result in an unacceptably high volume of clinically insignificant alerts and may negatively affect the development of critical thinking and clinical decision-making skills. This negative attitude may affect young graduates and trainees.…”

Can Today’s Medical School Faculty Teach Tomorrow’s Physicians about Patient-Centered Care?

“…7 Clinical decision support (CDS) systems within the EMR link health observations with health knowledge to influence health choices by clinicians. Tierney found that CDS can enhance learners' knowledge at the point of care by providing current information, best practices, and evidence-based care.…”