[MA 2024 17] The role of EHR and IT identity in medical education

eHealth Living & Learning Lab Amsterdam (ELLLA), Department of Medical Informatics, AmsterdamUMC - University of Amsterdam, Amsterdam -- Department of Educational Science, University of Groningen, Groningen

Proposed by: Harm Gijsbers, MSc, Assistant professor [h.j.gijsbers@amsterdamumc.nl]

Students from both departments are invited to apply for this research proposal. Ideally two students, one of each department, will work simultaneously and collaboratively on this research project.

Introduction

The introduction of Electronic Health Records (EHRs) into healthcare settings has brought about a significant transformation in the way medical information is accessed and shared. Use of an EHR is interwoven into even the most basic patient care tasks. Accordingly, learning how to utilize the EHR before, during and after patient encounters, (interdisciplinary) staff meetings and supervisory meetings is important for medical students as they develop their clinical skills. [1] Currently, the competency-based medical curricula do not seem to explicitly nor sufficiently prepare future physicians to provide high quality care with an EHR. [2] Multiple implementation studies identified the crucial role of attitudes, behaviours and identities of healthcare professionals for different levels of use and adoption of healthcare technology [3][4]. Yet, little is known about how medical students’ EHR use is shaped and how, in turn, this shapes their learning experiences.

Description of the SRP Project/Problem

The use of an EHR in medical education is still limited. In the context of the EHDS and WEGIZ, it is becoming increasingly important for students to learn how to use EHRs in their learning. For example, get students to report well so that data can be used for multiple purposes. Furthermore, it is also important to consider the advantage of the learning opportunities that the technology offers, such as checking in at the end of a shift to see how the patient with certain medications is doing. Or how to use supervision effectively using an EHR. And how to prepare consultations well so that reporting does not come at the expense of personal contact with the patient.

To do so, students must learn how to use an EHR. From a recent study – publication still in process – we know there are 5 personas or IT identities of healthcare professionals that influence learning and implementation of telemonitoring. We don't know whether IT identity among medical students or residents influence learning how to use an EHR.

Research questions

The main research question is: What is the role of an EHR in medical education? Sub-questions that can be answered are

- How can the EHR be used for good supervision?

- What does skills training look like in terms of communication skills with and around an EHR?

- How is self-directed education designed for learning to use an EHR?

- Are the same 5 personas or IT identities from implementation of telemonitoring applicable to learning how to use an EHR?

- If so, how does these student IT identities affect learning to use an EHR in medical education?

- How does student IT identity influence conversations with patients and supervisors when using an EHR?

Further research questions will be determined later, based on the student’s input.

Various research methods are possible in this assignment. For example, a scoping review, interviews, questionnaires, implementation questionnaires or persona research*. Students are expected to spend several days in the department of educational science in Groningen# to get an in-depth understanding of personas in implementation of eHealth and key questions in medical education in an increasingly digital world. Once students have gained a good impression, they are expected to make an informed choice on the research question and research methods in close consultation with the clients (ELLLA and Department of Educational Science, University of Groningen)

The student is expected to conduct a literature review on evaluation methods for digital healthcare applications in clinical learning environments. In addition, the student is expected to analyse basic evaluations and conduct in-depth interviews.

* Persona research like the blueprint project Blueprint | EUROPEAN INNOVATION PARTNERSHIP (archive-it.org)

# Groningen students spend several days in the AmsterdamUMC department

Expected results

The aim of this study is to gain an overview of the role of an EHR in the medical curricula of two Dutch Medical Schools, including the role of personas and IT identity of interns and residents “aiossen” and their influence on learning the use of EHRs.

As a result, we expect a scientific manuscript based on literature review and early evaluations. Furthermore, we expect some advice on research and actions for coming years. The manuscript describes the method and results of a study that shows the influence of IT identity on learning how to work with an EHR in medical curricula.

Time period

X November – June

X May - November

Contact

Harm Gijsbers, MSc, Assistant professor, eHealth Living & Learning Lab, Department of Medical Informatics, AmsterdamUMC, location University of Amsterdam, h.j.gijsbers@amsterdamumc.nl

Nienke Renting, PhD, Assistant Professor, Department of Educational Science, University of Groningen

References

1. Cristiano, J.A., et al., Integrating the Electronic Health Record Into Patient Encounters: An Introductory Standardized Patient Exercise for Preclinical Medical Students. MedEdPORTAL, 2022. 18: p. 11209.

2. Rajaram, A., et al., Training medical students and residents in the use of electronic health records: a systematic review of the literature. J Am Med Inform Assoc, 2020. 27(1): p. 175-180.

3. Gijsbers, H., et al., Enablers and barriers in upscaling telemonitoring across geographic boundaries: a scoping review. BMJ Open, 2022. 12(4): p. e057494.

4. Brands et al, manuscript in progress.