Going Paperless? Issues in Converting a Surgical Assessment Tool to an Electronic Version

Area of Science:

• Medical Education
• Surgical Training
• Health Informatics

Background:

• The healthcare industry is increasingly adopting electronic health records, aiming for paperless operations.
• Medical education is exploring electronic assessment tools for trainees, with prior literature suggesting positive outcomes.
• Despite potential benefits, hospitals implementing electronic health records often struggle to achieve paperless environments.

Purpose of the Study:

• To transition the validated Ottawa Surgical Competency Operating Room Evaluation from paper to an electronic format across three surgical specialties.
• To investigate the challenges and barriers encountered during the implementation of a paperless surgical assessment tool due to low participation rates.

Main Methods:

• A paper-based surgical competency assessment tool was adapted into an electronic version.
• The electronic tool was piloted in Orthopedic Surgery, Urology, and General Surgery.
• Study focus shifted to explore implementation barriers when low participation rates were observed.

Main Results:

• During the first 3 months, 440 cases were logged, but electronic assessment usage was low (Ortho: 16%, Urology: 5%, Gen Surg: 0%).
• Key barriers included increased time commitment compared to paper assessments and technical difficulties with the login process.
• Participants desired electronic tools that offered convenience comparable to traditional paper methods.

Conclusions:

• User preference for convenience mirroring paper-based methods is crucial for electronic assessment adoption.
• The transition to electronic assessment tools is not inherently neutral and faces significant implementation hurdles.
• Addressing identified barriers is essential to successfully leverage the advantages of electronic surgical competency assessments.