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Electronic-clinical evaluation exercise (e-CEX): A new patient-centered EHR use tool.

Maria Alcocer Alkureishi1, Wei Wei Lee2, Maureen Lyons3

  • 1Department of Academic Pediatrics, University of Chicago, Chicago, United States.

Patient Education and Counseling
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PubMed
Summary

A new tool, the electronic-clinical evaluation exercise (e-CEX), reliably assesses medical student communication skills when using electronic health records (EHRs). This validated tool can improve patient-provider interactions and patient experiences with EHRs.

Keywords:
CommunicationEHRElectronic health recordsElectronic medical recordsEvaluationPatient-provider relationship

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Area of Science:

  • Medical Education
  • Health Informatics
  • Communication Skills Training

Background:

  • Electronic Health Record (EHR) adoption impacts patient-provider communication, yet no validated tool exists to assess these skills.
  • Effective communication is crucial for optimal patient care and EHR utilization.

Purpose of the Study:

  • To develop and validate a tool for assessing patient-centered communication skills in the context of EHR use among medical students.
  • To establish the reliability and validity of the developed tool.

Main Methods:

  • The electronic-clinical evaluation exercise (e-CEX), a 10-item tool, was developed based on literature review and pilot testing.
  • Second-year (MS2) and third-year (MS3) medical students participated in Objective Structured Clinical Examinations (OSCEs) involving EHR use.
  • OSCEs were scored using e-CEX and a standardized patient (SP) tool to assess internal consistency, discriminant validity, and concurrent validity.

Main Results:

  • The e-CEX demonstrated high internal consistency (Cronbach's alpha=0.89).
  • MS2 students scored significantly higher than untrained MS3 students on e-CEX, confirming discriminant validity (P=0.003).
  • Strong correlation between e-CEX and SP scores (Pearson correlation=0.74, P<0.001) provided evidence of concurrent validity.

Conclusions:

  • The e-CEX is a reliable and valid instrument for evaluating medical students' patient-centered communication skills during EHR use.
  • A three-item version of the tool showed comparable explanatory power, suggesting potential for a brief assessment.
  • The e-CEX can contribute to improving provider communication behaviors and enhancing patient experiences with EHRs.