Predictors of student use of an electronic record

Abstract

Summary Background Little is known on ambulatory clerkship students’ use of an electronic medical record (EMR). We investigated students’ use of recommended EMR tasks across different types of sites and studied the predictors of these recommended tasks. Methods Students documented how often they performed recommended EMR tasks and suggested improvements to enhance EMR use. We compared student performance of recommended tasks across different types of sites using χ2 tests and the Fisher's exact test. We performed regression analyses to investigate factors predicting students’ performance of EMR tasks. Two faculty members read all of the suggested improvements and agreed on themes. Results From January 2014 to June 2015, 263 of 295 Family and Community Medicine Clerkship (FCMC) students (89.2%) were at sites that used an EMR. Of the 263 students, 68.4% typed their own note into the EMR, but only 31.2% entered orders and 27.8% entered prescriptions for their teacher to sign. Students’ rating of the orientation to the EMR predicted their use of all EMR tasks. The number of years that the teaching site used an EMR predicted the students’ use of some tasks. Suggested improvements included a better orientation to the EMR, more use of the EMR, and access to a computer and the EMR. Discussion Many students did not perform recommended EMR tasks. To help more students learn EMR tasks, clinical teachers can offer students a detailed orientation to their EMR, provide them with access to a computer and the EMR, and give them the opportunity to perform recommended EMR tasks, including typing their own note and entering orders and prescriptions.

EMR Precharting Efficiency in Internal Medicine: A Scoping Review

“… 14 Another survey described how medical students participate in informal EMR training, but “a formal orientation on how to use the EMR system would have been useful on the first day” and that including this training during an orientation would be beneficial. 15 This survey asked students after family and community medicine rotations to indicate whether or not they performed specific EMR tasks as well as providing free responses to open-ended survey questions. While some suggestions centered around access to computers or orders, there were multiple comments on the practicing of EMR skills in general.…”

An Exploratory Study of Allied Health Students' Experiences of Electronic Medical Records During Placements

“…These findings, particularly the variability in access, training, and support provided to allied health students across sites, are consistent with previous studies focused on nursing and medical student eMR experiences. 5,9,17 This suggests Table 2 Participant quotes to illustrate key themes that emerged from interviews…”

“…These findings, particularly the variability in access, training, and support provided to allied health students across sites, are consistent with previous studies focused on nursing and medical student eMR experiences. 5 9 17 This suggests that challenges faced by organizations in ensuring all students are credentialed, have access, and are appropriately trained for eMR use during placements are pervasive. The results add to this literature and highlight a critical need for dedicated resources, particularly workforce capacity (training and information technology [IT] staff), to ensure students receive consistent eMR exposure and support across placement settings, and are adequately prepared for clinical practice.…”

“…The survey instrument was informed by previous student surveys, 9 11 16 17 26 27 reviewed by the multi-disciplinary research team, and piloted with two allied health students, who suggested minor wording changes to some items. The survey comprised four sections (demographics, setting details, eMR access during placement, and opinions and preferences for eMR access) and 18 items in total, including 13 tick-box items, four Likert scales, and three free-text boxes (see Supplementary Appendix A , available in the online version).…”

“…Studies of medical and nursing student placements show significant variability across settings in the types and volume of documentation performed by students into eMRs. [8][9][10][11][12][13] Organizational policies regarding student eMR access also vary across placement sites. 14 Several barriers to student eMR access and documentation have been identified, including, for example, university and hospital policies and processes, concerns about medical liability, and logistical issues (e.g., training and access).…”