The Teaching EMR has a number of different tools you will not find in a traditional EMR/EHR, let alone one dedicated to education and learning used in medical schools and allied health professions education. Our clinical system that the Teaching EMR is a branch of has rule authoring capabilities built inside for non-programmers and clinicians to create rules and alerts to improve patient care. We have adopted that functionality for educators to create prompts within the system that has ripple effect for students to promote learning at any place inside the system.

Why a Teaching EMR?

The typical case presentation is done using paper today. It has a vignette that the student reads about the patient before providing them with the fake patient record to review and report out on for the learning exercise. This way of teaching students is very popular and has been done this way for a long time. I think we can all agree that education is evolving. It has to evolve. The Teaching EMR team has developed a system for doing case presentations, among other learning paths, using an EMR/EHR.

The Teaching EMR team has developed a unique system for doing case presentations, among other learning paths, using an EMR/EHR. While using and EHR/EMR is not necessarily unique to students, how we have adopted our clinical decision support rules engine for learning combined with the evaluation tools for education is unique. We give educators the ability to create vignettes, prompts, rules, alerts, and provide links out to other educational content for learning. From what we have seen and heard, no other EHR/EMR for learning can do what we have done for education.

Putting It Into Practice

As an example, students receive a prompt when they select a patient from the dashboard. Students receive a vignette of the patient and the learning objective that the educator would like for the student to walk through.

One traditional implementation of this for exercises inside or outside the classroom is for students to get prompted when they select a patient from the dashboard. The ‘patient story’ or vignette of the patient and the learning objective asks the students to read and select continue to acknowledge their completion (see screenshots) by selecting “Continue.”

temr_vignettescreenpatient-story

The student is then able to explore the anonymized patient and write reflection notes to communicate with their teacher.  Our system tracks the student’s activity and interactions inside the Teaching EMR and can be reported and analyzed. The evaluation capabilities are extremely valuable for both the student, educators, and administrators because the activity records can highlight student performance consistently across lessons, classes, years, campuses–all the while simulating activities they will all perform in clinical practice.

One thing you might notice about the ‘patient story’ above is the alert that is a popover, and on the right side, you will see that we have the ability to provide a persistent window for students of the information after they have closed out the popover by selecting ‘continue.’ This

Better Evaluation

In the example below you can see that I’ve not done a great job of navigating the patient’s record and completing the “gold standard” objective of reviewing and creating orders for the patient inside the Teaching EMR. Your students are going to do better than my 4 out of 18 or 22% performance on this exercise that was built with our RAVE (Rule Authoring and Validation Environment) inside the Teaching EMR. The great news is that I can see the areas where I missed diagnosed and failed to put in the gold standard of orders in the patient lesson.

Evaluation Screenshot

Evaluation Screenshot Example

If we school down and look a little closer, you can see the additional resources as a learner that I have been asked to review the topics covered in this lesson to ensure that I captured all the learning points and will help to ensure that I don’t perform so poorly in the future.

Learning Resources inside the popover window

The RAVE applications in the curriculum are only limited by my imagination. The team is actively working on some standard rules that we will share or you can easily create your own inside the administration toolkit inside of the Teaching EMR application–without needing a degree in computer science which is helpful for me and many of the faculty members, researchers, and clinicians that are already using RAVE.

RAVE

We would love to have a discussion with you on you might use the Teaching EMR with your students on your campus and how tools like our RAVE can promote and enhance learning.

Please contact a representative me, Brian Stout, to learn more.

Brian Stout

bristout@regenstrief.org