Impact of Electronic Medical Record Training on Pediatric Residents' Learning Outcomes: A Simulation-Based Study

Objective The objective of this study is to evaluate the impact of electronic medical record (EMR) training on pediatric residents' EMR proficiency and clinical decision-making in a simulated setting. Methods This was a prospective, non-blinded randomized controlled trial. Residents randomized into control and intervention groups participated in baseline simulated sepsis and respiratory distress scenarios. The intervention group received structured debriefing followed by EMR training relevant to the sepsis scenario, while the control group received the same debriefing without EMR training. The respiratory case was not debriefed. All residents participated in follow-up simulations three to six months later. The primary outcome was the change in the EMR proficiency score from baseline to follow-up as measured by an explicit checklist. The secondary outcome was residents' clinical decision-making in a simulated setting as measured by an intervention checklist. Results Twenty-eight residents completed the study. In the sepsis case, there was a significant improvement of 2.9 points (95% CI: 1.6, 4.2) in the intervention group EMR score, and a non-significant improvement in the control group. In the respiratory case, there was also a significant improvement of 3 points (95% CI: 1.7, 4.3) in the intervention group EMR score, and a non-significant improvement in the control group. For simulation performance, there was a non-significant improvement in both the intervention and control groups of 1.44 points (95% CI: -0.1, 2.9) and 0.77 points (95% CI: -0.7, 2.3) for the sepsis case, respectively. In the respiratory case, there was an improvement of 0.77 points (95% CI: 0.09, 1.5) in the intervention group and an improvement of 0.5 points (95% CI: -1.8, 1.2) in the control group. Conclusion Simulation-based EMR training can significantly improve EMR data gathering skills and may enhance clinical decision-making in a simulated environment. These results are limited by this study being a single-center and based on the local EMR, as this may impact generalizability.