The effect of computerized provider order entry on medical student clerkship experiences.
OBJECTIVE
To describe medical students' attitudes toward placing orders during training, and the effect of computerized provider order entry (CPOE) on their learning experiences.


METHODS
Prospective, controlled study of all 143 Johns Hopkins University School of Medicine students who began the Basic Medicine clerkship between March 2003 and April 2004 at one of three teaching hospitals: one using CPOE, one paper orders, and one that began using CPOE midway through this study.


METHODS
Survey of students at the start and after the first month of the clerkship.


RESULTS
Ninety-six percent of students responded. Students expressed a desire to place 100% of orders for their patients. Ninety-five percent of students believed that placing orders helps students learn what tests and treatments patients need. Eighty-four percent reported that being unavailable due to conferences and teaching sessions was a significant barrier to participating in the ordering process. Students at hospitals using CPOE reported placing significantly fewer of their patients' follow-up orders compared to students at hospitals using paper orders (25% vs. 50%, p < 0.01) and were more likely to report that their resident or intern did not want them to enter orders (40% vs. 16%, p < 0.01). Comparisons of students at hospitals using CPOE to each other showed that these differences were attributable to one of the hospitals. Thirty-two percent of students at both hospitals using CPOE reported that the extra length of time required for housestaff to review their orders in the computer was a significant barrier.


CONCLUSIONS
Hospitals need to ensure that the educational potential of medical students' clinical experiences is maximized when implementing CPOE.
Knight
Amy M
AM
CIMS Division, ASC Building, Room 262, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Baltimore, MD 21224, USA. aknight@jhmi.edu
Kravet
Steven J
SJ
Harper
G Michael
GM
Leff
Bruce
B
D001292:Attitude to Computers; D002982:Clinical Clerkship; D003625:Data Collection; D006751:Hospital Information Systems; D006801:Humans; D016347:Medical Records Systems, Computerized; D011446:Prospective Studies; D014584:User-Computer Interface