Clinical Informatics Education to Advance Learning Health Systems: A Scoping Review

Learning health systems leverage clinical data and knowledge to advance healthcare quality. Effective training in informatics concepts and tools is essential for medical trainees to become health system experts and contributors to positive organizational change. The objective of this study is to summarize characteristics of existing clinical informatics training programs and map these to recommended Learning Health System informatics competencies. We aim to answer the following research questions: (1) How are academic medical institutions implementing informatics education initiatives for medical trainees? (2) Are these initiatives implementing recommended informatics competencies? and (3) How effective are these initiatives according to established health professions education evaluation frameworks?

We searched for literature in the databases Embase, Ovid Medline, and Web of Science. Three researchers independently screened study titles and abstracts. Inclusion criteria were (a) studies with medical students and/or postgraduate medical professionals in the study sample, (b) in an academic medical setting, and (c) describing a clinical informatics curriculum initiative.

We included a total of 27 studies for analysis. Most curricula (n = 16) had the objective of basic informatics knowledge acquisition. Instruction delivery for most (n = 17) included a combination of didactic and practical components. The most common evaluation tool was student self-reported confidence and self-efficacy. All but three of the studies integrated the recommended informatics competency of demonstrating knowledge of clinical information systems such as Electronic Health Records. Most studies (n = 12) reported outcomes related to the Kirkpatrick Level II of Learning.

Gaps remain in the context of leveraging education to pursue Learning Health System endeavors of clinical research, quality improvement, and achieving organizational-level results. Further research on recent education initiatives targeting undergraduate and graduate medical trainees is needed to elevate the rate of clinical informatics education implementation, while simultaneously advocating for standardization in the design and evaluation of these initiatives.