Enhanced Ambulatory Electronic Health Record Training for Residents: Prospective Cohort Study. (Preprint)
BACKGROUND Physicians spend a significant amount of time with Electronic Health Record (EHR) systems but receive inadequate training. Prior studies have shown benefit from intern orientation programs such as “boot camps” for clinical knowledge or skills but few have examined courses for enhanced EHR orientation. OBJECTIVE To improve EHR clinic workflow processes and assess the impact of a structured course on intern confidence and preparedness. METHODS One faculty and two resident physicians spent approximately 30 hours creating a four-hour course curriculum, which was taught to a group of incoming Internal Medicine interns in June and July 2017. The interns completed a course feedback survey along with self-reported outpatient EHR workflow process confidence surveys at 1, 6, and 12 months. A control group also completed the same confidence surveys at the same intervals. RESULTS A total of 15 out of 18 Internal Medicine interns (83%) took the course. All 15 reported they learned useful information and had increased overall confidence. A majority (93%) agreed the course would allow them to provide better care for their patients and that the course content was best delivered by a physician. Most interns (80%) agreed the course should be a required part of internship. Confidence scores in eight major workflow areas significantly increased after the course and persisted throughout intern year. A control group of interns had low initial confidence scores that increased at 6 and 12 months. CONCLUSIONS A 4-hour targeted EHR ambulatory training course was feasible, highly rated, and increased workflow confidence scores for the first 6 months.