Council on Medical Student Education in Pediatrics

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COMSEP Meeting in Ottawa, ON

Poster Presentation:


Third Year Medical Student Electronic Health Record and Computerized Provider Order Entry Use: A Survey of North American Pediatric Clerkship Directors

Authors:
Marta King,St Louis University School of Medicine,St. Louis,MO,Paula Buchanan,Saint Louis University,St. Louis,MO,Mitzi Scotten,University of Kansas Medical Center,Kanas City ,KS,Su-Ting Li,University of California Davis School of Medicine,,,Ryan Lin,Saint Louis University School of Medicine,,

Objectives: With the increasing adaptation of the electronic health record (EHR), opportunities and expectations regarding students’ clinical documentation are evolving. Our goal was to describe medical student EHR and computerized provider order entry (CPOE) use during pediatric clerkships in North American medical schools.

Methods: We included questions regarding third year medical student EHR and CPOE use during inpatient portion of the pediatric clerkship with the 2014 Council on Medical Student Education in Pediatrics annual member survey.  Results were summarized using descriptive statistics. 

Results: A total of 179 participants representing 101 Liaison Committee for Medical Education accredited medical schools responded to the survey with an institutional response rate of 46.5%.  Of received responses, 95% of pediatric clerkships utilize EHR at the primary inpatient third year medical student training site with Epic and Cerner being the most widely used platforms. Of the sites that utilize EHR, 95% allow third year medical student EHR access. Student access closely matches physician access, with the exception of CPOE function which is utilized by 44% of physicians and 18% of students. The most common rationale of allowing student EHR documentation were learning exercise (36%) and increased student involvement in patient care (36%). The most common reasons for NOT allowing student EHR documentation were concerns for legal ramifications (7%), lack of time to review student documentation (6%), and potential for inappropriate billing of student notes (6%). Similar results were reported for student CPOE use.

Discussion: Utilizing EHRfor documentation is an Accreditation Council for Graduate Medical Education competency. In order to gain knowledge and competency in this domain, medical students would benefit from early exposure and practice with EHR and CPOE. Our survey demonstrates the current variation among medical schools in regards to student access to EHR documentation but specifically in the ability to interact with the CPOE domain. Medical schools recognize that EHR access is an important learning tool and that this access increases student perception of participation in the medical team. Limitations to access still remain and concerns for legal ramifications, inaccurate billing and lack of time to oversee EHR usage will need to be addressed by medical schools and hospital administrations.