title: Personal health records in the preclinical medical curriculum: modeling student responses in a simple educational environment utilizing Google Health.
abstract: BACKGROUND
  Various problems concerning the introduction of personal health records in everyday healthcare practice are reported to be associated with physicians' unfamiliarity with systematic means of electronically collecting health information about their patients (e.g. electronic health records--EHRs). Such barriers may further prevent the role physicians have in their patient encounters and the influence they can have in accelerating and diffusing personal health records (PHRs) to the patient community. One way to address these problems is through medical education on PHRs in the context of EHR activities within the undergraduate medical curriculum and the medical informatics courses in specific. In this paper, the development of an educational PHR activity based on Google Health is reported. Moreover, student responses on PHR's use and utility are collected and presented. The collected responses are then modelled to relate the satisfaction level of students in such a setting to the estimation about their attitude towards PHRs in the future.
  
  
  METHODS
  The study was conducted by designing an educational scenario about PHRs, which consisted of student instruction on Google Health as a model PHR and followed the guidelines of a protocol that was constructed for this purpose. This scenario was applied to a sample of 338 first-year undergraduate medical students. A questionnaire was distributed to each one of them in order to obtain Likert-like scale data on the sample's response with respect to the PHR that was used; the data were then further analysed descriptively and in terms of a regression analysis to model hypothesised correlations.
  
  
  RESULTS
  Students displayed, in general, satisfaction about the core PHR functions they used and they were optimistic about using them in the future, as they evaluated quite high up the level of their utility. The aspect they valued most in the PHR was its main role as a record-keeping tool, while their main concern was related to the negative effect their own opinion might have on the use of PHRs by patients. Finally, the estimate of their future attitudes towards PHR integration was found positively dependent of the level of PHR satisfaction that they gained through their experience (rho=0.524, p<0.001).
  
  
  CONCLUSIONS
  The results indicate that students support PHRs as medical record keeping helpers and perceive them as beneficial to healthcare. They also underline the importance of achieving good educational experiences in improving PHR perspectives inside such educational activities. Further research is obviously needed to establish the relative long-term effect of education to other methods of exposing future physicians to PHRs.
authors.affiliation: Lab of Medical Informatics, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Dimokratis A
authors.initials: DA
authors.lastname: Karamanlis
authors.forename: Panagiotis M
authors.initials: PM
authors.lastname: Tzitzis
authors.forename: Charalampos A
authors.initials: CA
authors.lastname: Bratsas
authors.forename: Panagiotis D
authors.initials: PD
authors.lastname: Bamidis
mesh_terms: D003479:Curriculum; D004504:Education, Medical, Undergraduate; D055991:Health Records, Personal; D006801:Humans; D057386:Search Engine; D013337:Students, Medical / Q000523:psychology*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods; D014584:User-Computer Interface