Ready for Class
The tEMR is a unique learning tool designed to recreate clinical environments. These “care environments” include inpatient, outpatient and emergency department care settings. The system is intended to support an in-depth curriculum in health care delivery science, clinical decision making, and medical informatics across all years of medical and health professions education.
The Teaching EMR is designed to safely allow students to care virtually for patients with tools they will use one day as practicing physicians. The system contains an extensive, de-identified and misidentified patient database, a computerized order entry system (CPOE) and the tools to allow educators to deliver educational content to learners in innovative ways.
The evaluation functionality built into the system is unique and perhaps more significant than the content delivery systems. The tEMR’s tracks user actions in the system. Mapping user actions to entrustable behaviors provides a methodology for educators to assess user competence in the meaningful use of EMR’s and medical decision making longitudinally.
Also, other healthcare professionals can use the system for learning. Medical and other healthcare educators have already endorsed the potential for using the tEMR for interprofessional education (IPE).
Currently, most medical schools do not have a student electronic health record that allows entering teaching history and physical exam skills in an EMR, and many continue to use paper and pencil methods. Case studies, for problem-based learning and pathophysiology courses, are also generated individually and provided without the benefit of real patient data that exists within the EMR. Students do not have access to population data or exemplar registries.
While students are trained to use an EMR at most medical schools, the training is superficial, focusing on the concepts of login, data entry, and patient privacy and does not provide students with a deeper understanding of the functionality and potential usefulness of an electronic platform for patient care. However, it is important to note that the primary purpose of the Regenstrief Institute Teaching EMR is NOT to train students to use an EMR, but rather to train them in the core skills of clinical informatics and medical decision making.
Instead, the benefit of learning this curriculum within a tEMR environment means that students will quickly transfer core skills of a facility with EMR use to vendor specific EMRs used at their medical school, residency program and future practice locations.
Building a Virtual Health System
The Indiana University School of Medicine (IUSM) has developed a longitudinal curriculum to teach core clinical skills to second and third-year medical students using the tEMR. A syllabus of the first six modules of their 12 unit second year course is available here.
Students learn history and physical exam documentation, chart review with data retrieval skills, health care funding’s impact on care, generating and reviewing medication lists, cost comparison medication choices, and the effects of health insurance on out-of-pocket and medication costs to patients. Feedback from students and instructors across the nine statewide campus locations on the use of the tEMR has been uniformly positive.
We have developed comprehensive faculty and student on-line tutorials to support this new curriculum across distributed sites. Using the example school curricula, tutorials, and faculty development resources available can be a discussion starter for your program.
Are you ready for an EMR/EHR built for learning and evaluation?
Sr. Product Manager – Teaching EMR
Center for Biomedical Informatics