Medical schools are not providing students with sufficient training on the use of electronic health record systems, according to a study published recently in the journal Teaching and Learning in Medicine, Modern Physician reports (Selvam, Modern Physician, 8/13).
Study Findings
The study, based on an Alliance for Clinical Education survey, finds that medical students' ability to access EHR systems varies.
According to the survey, 64% of medical schools allow students to use EHR systems and two-thirds of those schools allow students to make notes in EHRs.
It also found that 27% of survey respondents said students are allowed to view and write patient notes and enter patient orders to be co-signed.
Meanwhile, 41% of respondents said students can view and write notes in EHRs but not make orders, according to the survey.
Lynn Cleary -- a professor at Upstate Medical University at the State University of New York and president of the alliance -- said that although the majority of students are permitted to enter notes in EHRs, many schools do not consider their notes part of the official EHR.
Barriers to EHR Use in Medical Schools
According to the survey, barriers to EHR training at medical schools include:
- A steep learning curve for faculty members who are unaccustomed to using EHR systems;
- Concerns about billing challenges;
- Lack of computers available for instructional purposes;
- Lack of a mechanism that allows residents or faculty to review student order entries; and
- The possibility of student errors going undetected because of the structure of certain EHR systems.
Recommendations
In conjunction with the study, the alliance published recommendations for implementing EHR instruction in medical schools.
The recommendations include:
- Allowing students to perform order entry in real or simulated cases;
- Exposing students to decision aids that are built into many EHR systems; and
- Permitting students to make notes in patients' EHRs.
Comments
Cleary said that medical schools "have a responsibility to graduate students with the expertise and sense of duty in the basics of practice," adding that the use of EHR systems are "now part of that skill set."
Maya Hammoud -- lead author of both articles and associate professor of obstetrics and gynecology at the University of Michigan Medical School -- said, "We hope that medical schools and faculty recognize that students need to be more integrated in the team and not excluded from utilizing the EHR."
She added, "This can jeopardize their learning and their effectiveness as future physicians" (Krupa, American Medical News, 8/13).