The Impact of Electronic Health Record-Based Simulation During Intern Boot Camp: Interventional Study

Area of Science:

• Medical Education
• Health Informatics
• Clinical Workflow Optimization

Background:

• Accurate data retrieval is critical for patient care in the intensive care unit (ICU).
• Electronic Health Records (EHRs) are the primary tool for data storage and review.
• Previous studies indicated varied and nonstandard approaches to EHR data retrieval among residents, leading to errors in patient safety recognition.

Purpose of the Study:

• To assess the impact of a novel, simulation-based EHR learning activity on intern data gathering workflow.
• To evaluate intern satisfaction with the EHR learning activity.
• To determine if the training decreases variability in EHR use among interns.

Main Methods:

• 72 internal medicine interns participated in a 1-hour EHR training session.
• Training focused on high-fidelity simulation of ICU patient charts and best navigation practices.
• EHR screen navigation was recorded and compared to a reference group of residents (N=62).
• Learner satisfaction and screen preferences were surveyed immediately and 6 months post-training.

Main Results:

• Intervention interns used more individual screens (18 vs 20; P=.008) but similar total screens (35 vs 38; P=.30) compared to reference residents.
• Significantly more intervention interns utilized the 10 most common screens (73% vs 45%; P=.001).
• Intervention interns consistently favored high-yield over low-yield screens, a pattern persisting at 6 months.

Conclusions:

• A brief, high-fidelity simulation-based EHR training is enjoyable and effectively modifies navigation patterns.
• The observed changes in navigation behavior were persistent 6 months post-training.
• Workflow-specific, simulation-based EHR training offers significant educational benefits for residents throughout their training.