MONTREAL – A hands-on training program designed to improve communication between physicians and allied health professionals, such as physical therapists, produced gains in comfort and confidence to medical students who completed the training.
After completing the training, which involved both a didactic and a hands-on component, 92.58% of third-year medical students agreed or strongly agreed that they had the skills needed for effective interprofessional communication in the EHR, up from 43.86% before the training.
Kari Oakes/Frontline Medical News
Dr. Zaiba Jetpuri
The idea for the training began when Zaiba Jetpuri, DO, and her physician colleagues at the University of Texas Southwestern Medical Center, Dallas, noticed that medical students and residents often were unsure how best to communicate with nurses, pharmacists, physical therapists, and other members of the healthcare team via the EHR.
Knowing who has what role in an interdisciplinary setting is far from obvious, and knowing how to strike the right tone in EHR communications was a challenge for trainees, Dr. Jetpuri said in an interview during her poster presentation at annual meeting of the North American Primary Care Research Groups.
To address such uncertainties, which can impact both quality and continuity of care, Dr. Jetpuri and her colleagues devised an intervention aimed at third-year medical students who were doing family medicine clerkships. The intervention has been given to about 360 students thus far.
The intervention consisted of two components. The first, a didactic module, delivered information about the importance of professionalism and teamwork and also defined interprofessional roles.
The second phase of the training had students using the “sandbox” of Epic, UT Southwestern’s EHR, to practice responding to hypothetical messages from a patient, a nurse, a pharmacist, and a physical therapist. One message would arrive in the medical student’s EHR inbox each week, and the student would have the week to craft a response.
Dr. Jetpuri said that she and her colleagues worked hard to make the scenarios as realistic as possible: The lengthy patient email included several questions about the safety of taking supplements or herbal remedies. They also tried to make sure that the nuts and bolts of interprofessional communication were covered so that, for example, medical students would end a module knowing what should be included when writing orders for physical therapy and how to place the order correctly.
The responses then went through peer evaluation according to a rubric constructed by the investigators. The training and evaluation were designed to make sure that students acquired a better understanding of the mechanics of EHR interprofessional communication and of the soft skills needed for collegial and professional communication.
Dr. Jetpuri said that she and her colleagues would like to extend this realistic educational tool through the clerkship year for better continuity. They also are working on some technical aspects of the EHR to make communication easier for medical students. Furthermore, they are in the process of validating the peer evaluation process by having instructors use the rubric to duplicate the students’ evaluation. She said, though, that both trainees and faculty see the value in early, realistic experience using the electronic record in a multidisciplinary team.
“Simulated EHR experiences are an important tool to utilize in a medical school curriculum to better train and prepare our students for the postgraduate stage,” wrote Dr. Jetpuri and her colleagues.
Dr. Jetpuri reported that she has no conflicts of interest.
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