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Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting.

Electronic health record training in undergraduate medical education: bridging theory to practice with curricula for empowering patient- and relationship-centered care in the computerized setting. Wald, H. S et. al. Acad Med 89, 380–386 (2014).

OVERVIEW

This Perspective looks at bridging theory into practice with systematic longitudinal curriculum development for undergraduate medical education. Curriculum components that are not solely technical, such as the integral role of the narrative in health care, contemporary educational scholarship etc. were critical to this approach as well as the standard competency-based approach.

KEY FEATURES

Longitudinal integration occurred within an existing course at Brown (“Doctoring”) in two places within the curriculum:

3rd year - Integration of an initial electronic health record (EHR) training course within the third-year clinical skills clerkship with both didactic and practical methods used + reflective self-assessment.

4th year - An advanced EHR training module in a fourth-year internship preparation elective was meant to increase appreciation for potential added value of integrated computer use for “information mastery,” to engage patients with their health care narrative, and to foster effective, empathic communication and care.

The authors propose four curriculum objectives for a UME EHR curriculum innovation: (1) introducing students to the presence of a computer within a clinical encounter; (2) training students in EHR-related skills; (3) empowering patient- and relationship-centered interviewing skills while incorporating EHR skills; and (4) fostering students’ appreciation for added value of integrated computer use within the clinical encounter.

BOTTOM LINE

The impact of the EHR on the patient-physician relationship and effective use of healthcare technologies must be addressed in training to enable learners to foster, rather than diminish, relationships and effective communication as they integrate EHRs into the patient encounter. Curriculum components that are not solely technical and more in line with a humanities approach (such as critical “non-conventional” competencies, the integral role of the narrative in health care, contemporary educational scholarship, reflective learning, etc.) are critical.

COMMENTARY

The authors provide a robust curriculum example of e-health learning at their home institution. The integration took place in an existing longitudinal course, making it practical for integration into other institutions as it does not require the creation of a brand new modality. The curriculum example is well-described in terms of what was done and what competencies and skills were assessed. Overall, a good example of e-health integration into UME. 4/5 checks.