Copy-and-Paste in Medical Student Notes: Extent, Temporal Trends, and Relationship to Scholastic Performance.

Area of Science:

• Medical Education
• Clinical Documentation
• Health Informatics

Background:

• Medical students may inadvertently perpetuate documentation redundancy.
• The extent of redundancy in student notes and its link to academic performance are not well understood.

Purpose of the Study:

• To quantify text redundancy in medical student clinical notes.
• To investigate the association between note redundancy and objective measures of student performance, such as USMLE scores.

Main Methods:

• Analyzed notes from medical students during their medicine clerkship.
• Defined student-patient interactions (SPIs) and calculated text redundancy using edit distance.
• Correlated note redundancy with United States Medical Licensing Examination (USMLE) scores.

Main Results:

• High redundancy (40%) was observed in the assessment/plan section, increasing within SPIs (to 60%) and between SPI pairs over the clerkship.
• Students with lower USMLE Step II scores exhibited significantly higher redundancy in the assessment/plan section (67% vs. 38%).

Conclusions:

• Redundancy in medical student notes, especially in the assessment/plan section, increases with clinical experience and patient encounters.
• This trend may suggest underlying issues with clinical knowledge or reasoning, as indicated by standardized test performance.