title: Assessment of emergency medicine residents' computer knowledge and computer skills: time for an upgrade?
abstract: OBJECTIVE
  To describe emergency medicine residents' (EMRs') personal computer (PC) use and educational needs and to compare their perceived and actual PC skills.
  
  
  METHODS
  This was a prospective, cross-sectional study. Subjects were all EMRs at seven midwestern Accreditation Council for Graduate Medical Education (ACGME) residency programs. The EMRs completed a questionnaire about their PC use and ability to perform 23 tasks derived from two national retail-training programs. The tasks covered word processing, slide making, and Internet use. The EMRs then took a three-part test performing the skills in the questionnaire. Two independent raters scored the tests. Frequencies with 95% confidence intervals (95% CIs) were calculated for categorical data. Positive and negative predictive values were used to report information comparing residents' performance with their self-assessment of skills. Cohen's kappa was used to test agreement between raters.
  
  
  RESULTS
  One hundred twenty-four of 158 (79%) eligible EMRs participated. Since not all participants engaged in all parts of the study, the sample size varies between 121 and 124. One hundred one of 122 (83%; 95% CI = 75 to 89) owned a PC. The EMRs use home PCs a mean of 3.8 hours/week for physician duties and use residency PCs 1.9 hours/week (range 0-20). Ninety-six of 122 (79%; 95% CI = 70 to 86) EMRs reported no formal PC training during residency. Thirty-five percent (43/122; 95% CI = 27 to 44) passed the word-processing test and 50% (62/123; 95% CI = 41 to 60) passed the slide-making test. Reasons for failure were because of errors and not having a presentable product. Thirty-eight of 122 (31%; 95% CI = 23 to 40) failed the literature search, including 33 who said they could perform it. One hundred fifteen of 123 (94%; 95% CI = 88 to 98) EMRs were able to find an Internet address, including ten who stated they could not. Twenty-one percent of the residents who attempted any test (26/124; 95% CI = 14 to 29) passed all three tests. There was no association between year of training and success on the tests (p = 0.374). Thirty-seven of 115 (32%; 95% CI = 24 to 42) EMRs said they had insufficient PC training to meet their physician needs.
  
  
  CONCLUSIONS
  Emergency medicine residents have much access to computer technology and possess some computer skills; however, many are unable to produce a usable product or conduct a literature search. Emergency medicine residents have not had sufficient computer training prior to residency. The computer skills of EMRs should be assessed through skills testing rather than self-assessment, and computer training during residency should be improved.
authors.affiliation: Department of Emergency Medicine, Northeastern Ohio Universities College of Medicine, Summa Health System, Akron, OH 44304, USA. jwayyeds@summa-health.org
authors.forename: Sharhabeel
authors.initials: S
authors.lastname: Jwayyed
authors.forename: Tammy K
authors.initials: TK
authors.lastname: Park
authors.forename: Michelle
authors.initials: M
authors.lastname: Blanda
authors.forename: Scott T
authors.initials: ST
authors.lastname: Wilber
authors.forename: Lowell W
authors.initials: LW
authors.lastname: Gerson
authors.forename: Sharon O
authors.initials: SO
authors.lastname: Meerbaum
authors.forename: Michael S
authors.initials: MS
authors.lastname: Beeson
mesh_terms: D003197:Computer Literacy; D003200:Computer User Training; D003201:Computers / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000706:statistics & numerical data; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis