Medical residents can benefit from workflow-specific EHR training

A recent study finds that an electronic health record simulation was both enjoyable and effective at changing behavior.
By Kat Jercich
11:55 AM

A study published in JMIR Medical Education found that an electronic health record simulation provided during the first year of residency was enjoyable and effective at changing behavior.  

Researchers from Oregon Health and Science University found that participants in the EHR simulation activity found it useful both immediately and after six months.   

"This suggests that workflow-specific simulation-based EHR training throughout training is of educational benefit to residents," they wrote in the study.  


The researchers note that the widespread use of EHRs has led to a number of unintended consequences – including potential patient harm when information is not properly entered, retrieved or processed.  

They also flag the increase in burnout levels, explaining that EHR complexity has increased the amount of time providers spend documenting.

"Central to addressing both of these issues is the improvement in EHR education to ensure providers are capable of safe, effective, and efficient use of the EHR in the context of their specific, daily workflow," the study reads.

The OHSU team also cited residents' desire for more EHR education, along with the challenges in implementing it.  

"The utilization of EHR simulations that feature patient records has gained traction as a solution for these problems in EHR education because, as stated by a national consensus conference, simulation is capable of matching EHR training with provider-specific workflow," they write.  

To address that need, the team had previously developed high-fidelity simulated patient EHR cases to assess safe and effective EHR use. This time they explored whether a simulated exercise focused on EHR navigation would be well-liked and useful.

The researchers used a copy of Epic, which duplicates user preferences without displaying authentic patient information, to host the simulated cases. They offered the training to 71 first-year internal medicine residents at OHSU during a week-long boot camp.

The team found that the interns found the activity to be enjoyable, useful, meaningful, appropriately paced and appropriately challenging.  

They also found that the intervention was associated with an increase in the standardization of EHR use, which in turn was associated with an increase in the use of high-yield screens and a decrease in the use of low-yield screens.  

"The data collected in this study suggests not only that our activity was able to modify participant behavior effectively, but also that these changes were sustained long beyond the activity," wrote the researchers.  


Nearly a decade ago, OHSU invested $1 million toward research aimed at addressing the challenges connected to EHR systems, including the development of simulation environments.

The principal investigator on that grant, Dr. Jeffrey Gold, said that in doing so the team was "building a better mouse and a mouse trap at the same time.” Gold also coauthored the JMIR study.  

Since then, a number of vendors have developed simulation software to assist with training. This past year, KLAS praised Atos' tools, which clients called effective and worth the price tag.  


"We found navigation patterns to closely match expert recommendations after the activity," wrote the researchers.   

"The ability to deliver this content in a short time frame allows for the rapid expansion of this methodology not only during onboarding, but also throughout the continuum of their training," they added.


Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Healthcare IT News is a HIMSS Media publication.

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