The Impact of Electronic Health Records on Family Physicians During Simulated Virtual Encounters: Exploratory Mixed...

Area of Science:

• Medical Education
• Health Informatics
• Clinical Simulation

Background:

• Exploratory study on computer use impact on physician performance in clinical simulations.
• Standardized patient scenarios adapted for electronic health record (EHR) integration.

Purpose of the Study:

• Compare EHR impact on resident vs. staff physicians' patient-centeredness (PC) and clinical performance.
• Measure cognitive load (CL) associated with EHR use during virtual patient encounters.

Main Methods:

• 16 participants completed 2 video telemedicine simulations with standardized patients.
• EHR use, PC, overall performance, and self-perceived CL (NASA-TLX) were assessed.
• Qualitative coding identified stress/CL signs; computer interaction time was calculated.

Main Results:

• Staff physicians scored higher on PC, but not significantly different from residents.
• Physician cognitive load did not significantly correlate with computer use.
• Qualitative analysis revealed verbal and nonverbal stress/CL signs linked to simultaneous computer and patient interaction.

Conclusions:

• Computer use during telemedicine may negatively affect physician PC and clinical performance.
• Clinical experience appears to mitigate negative impacts of computer use.
• Clear guidelines for EHR tasks are necessary for certification exams incorporating EHR use.