Abstract
Background Conventional classroom Electronic Health Record (EHR) training is often insufficient
for new EHR users. Studies suggest that enhanced training with a hands-on approach
and closely supported clinical use is beneficial.
Objectives Our goals were to develop an enhanced EHR learning curriculum for Post Graduate Year
1 (PGY1) residents and measure changes in EHR skill proficiency, efficiency, and self-efficacy.
Methods A novel three-phase, multimodal enhanced EHR curriculum was designed for a cohort
of PGY1 residents. After basic training, residents began phase 1 of enhanced training,
including demonstrations, live practice, and order set review. Phase 2 involved skills-oriented
assignments, role playing, and medication entry. Phase 3 included shadowing, scribing
histories, and supervised order entry. Residents' EHR skills and attitudes were measured
and compared before and after the enhanced curriculum via proficiency test and a survey
of efficiency and self-efficacy.
Results Nineteen of 26 PGY1 residents participated in the study (73%). There was significant
improvement in mean proficiency scores and two of the five individual proficiency
scores. There were significant improvements in most efficiency survey responses from
pre- to postintervention. For the self-efficacy presurvey, many PGY1s reported to
be “very” or “somewhat confident” performing each of the five tasks, and perceptions
did not improve or worsened on most postsurvey responses. The greatest resource was
the time required to design and deliver the enhanced training.
Conclusion An enhanced training curriculum along with a proficiency assessment was developed
and described here. An enhanced training curriculum significantly improved PGY1 EHR
efficiency and some measures of proficiency but not self-efficacy. This intervention
may support improved EHR-related clinic workflows, which ultimately could enable residents
and preceptors to prioritize patient care and time for clinical education.
Keywords
electronic health record - EHR - research - resident - EHR training - primary care
- learner - assessment
