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Evaluating the Impact of Computerized Provider Order Entry on Medical Students Training at Bedside: A Randomized
Maxime Wack1, Etienne Puymirat2, Brigitte Ranque3
1Biomedical informatics and public health department, HEGP, AP-HP, Paris Descartes University, Paris, France; INSERM UMR S 872 team 22, Faculté de Médecine, Paris Descartes University, Paris, France.
Objective:
To evaluate the impact of computerized provider order entry (CPOE) at the bedside on medical students training.
Materials And Methods:
We conducted a randomized cross-controlled educational trial on medical students during two clerkship rotations in three departments, assessing the impact of the use of CPOE on their ability to place adequate monitoring and therapeutic orders using a written test before and after each rotation. Students' satisfaction with their practice and the order placement system was surveyed. A multivariate mixed model was used to take individual students and chief resident (CR) effects into account. Factorial analysis was applied on the satisfaction questionnaire to identify dimensions, and scores were compared on these dimensions.
Results:
Thirty-six students show no better progress (beginning and final test means = 69.87 and 80.98 points out of 176 for the control group, 64.60 and 78.11 for the CPOE group, p = 0.556) during their rotation in either group, even after adjusting for each student and CR, but show a better satisfaction with patient care and greater involvement in the medical team in the CPOE group (p = 0.035*). Both groups have a favorable opinion regarding CPOE as an educational tool, especially because of the order reviewing by the supervisor.
Conclusion:
This is the first randomized controlled trial assessing the performance of CPOE in both the progress in prescriptions ability and satisfaction of the students. The absence of effect on the medical skills must be weighted by the small time scale and low sample size. However, students are more satisfied when using CPOE rather than usual training.
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