Experience of introducing an electronic health records station in an objective structured clinical examination to evaluate medical students’ communication skills in Canada: a descriptive study
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Purpose There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study explored the feasibility of an EMR objective structured clinical examination (OSCE) station to evaluate medical students’ communication skills by psychometric analyses and standardized patients’ (SPs) perspectives on EMR use in an OSCE. Methods An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2020. Students’ communication skills were assessed by SPs and physician examiners. Students’ scores were compared between the EMR station and 9 other stations. A psychometric analysis, including item total correlation, was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs’ effect on communication. Results Ninety-nine 3rd-year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P=0.041). The thematic analysis of SPs’ perceptions of students’ EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage. Conclusion This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aid in patient counseling. Teaching students how to be patient-centered even in the presence of technology may promote engagement.
Abstract
Purpose There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study explored the feasibility of an EMR objective structured clinical examination (OSCE) station to evaluate medical students’ communication skills by psychometric analyses and standardized patients’ (SPs) perspectives on EMR use in an OSCE. Methods An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2020. Students’ communication skills were assessed by SPs and physician examiners. Students’ scores were compared between the EMR station and 9 other stations. A psychometric analysis, including item total correlation, was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs’ effect on communication. Results Ninety-nine 3rd-year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P=0.041). The thematic analysis of SPs’ perceptions of students’ EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage. Conclusion This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aid in patient counseling. Teaching students how to be patient-centered even in the presence of technology may promote engagement.
참고문헌 (15)
- Beard L, "The challenges in making electronic health records accessible to patients", J Am Med Inform Assoc, 19, pp.116~120 (2012)[DOI]
- Alkureishi MA, "Impact of electronic medical record use on the patient-doctor relationship and communication : a systematic review", J Gen Intern Med, 31, pp.548~560 (2016)[DOI]
- Crampton NH, "Computers in the clinical encounter : a scoping review and thematic analysis", J Am Med Inform Assoc, 23, pp.654~665 (2016)[DOI]
- Shen E, "The electronic health record objective structured clinical examination station : assessing student competency in patient notes and patient interaction", MedEdPORTAL, 16, pp.10998~ (2020)[DOI]
- Kleib M, "Academic electronic health records in undergraduate nursing education : mixed methods pilot study", JMIR Nurs, 4, pp.e26944~ (2021)[DOI]
- Roy M, "Augmenting physician examiner scoring in objective structured clinical examinations : including the standardized patient perspective", Adv Health Sci Educ Theory Pract, 26, pp.313~328 (2021)[DOI]
- Braun V, "One size fits all?: what counts as quality practice in (reflexive) thematic analysis?", Qual Res Psychol, 18, pp.328~352 (2021)[DOI]
- Brundage M, "Communicating quality of life information to cancer patients : a study of six presentation formats", J Clin Oncol, 23, pp.6949~6956 (2005)[DOI]
- Lipkus IM, "Numeric, verbal, and visual formats of conveying health risks : suggested best practices and future recommendations", Med Decis Making, 27, pp.696~713 (2007)[DOI]
- Nayak JG, "Relevance of graph literacy in the development of patient-centered communication tools", Patient Educ Couns, 99, pp.448~454 (2016)[DOI]
- Shirazi M, "Assessing medical students’ communication skills by the use of standardized patients : emphasizing standardized patients’ quality assurance", Acad Psychiatry, 38, pp.354~360 (2014)[DOI]
- van Zanten M, "Using standardized patients to assess the interpersonal skills of physicians : six years’ experience with a high-stakes certification examination", Health Commun, 22, pp.195~205 (2007)[DOI]
- Guiton G, "Communication skills in standardized-patient assessment of final-year medical students : a psychometric study", Adv Health Sci Educ Theory Pract, 9, pp.179~187 (2004)[DOI]
- McGrath JM, "The influence of electronic medical record usage on nonverbal communication in the medical interview", Health Informatics J, 13, pp.105~118 (2007)[DOI]
- Hall JA, "The medical interview: clinical care, education, and research", pp.495~503 (1995), Springer