A Pilot Study of Computer-Based Simulation Training for Enhancing Family Medicine Residents' Competence in Computerized Settings.
We previously developed a prototype computer-based simulation to teach residents how to integrate better EMR use in the patient-physician interaction. To evaluate the prototype, we conducted usability tests with three non-clinician students, followed by a pilot study with 16 family medicine residents. The pilot study included pre- and post-test surveys of competencies and attitudes related to using the EMR in the consultation and the acceptability of the simulation, as well as 'think aloud' observations. After using the simulation prototypes, the mean scores for competencies and attitudes improved from 14.88/20 to 15.63/20 and from 22.25/30 to 23.13/30, respectively; however, only the difference for competencies was significant (paired t-test; t=-2.535, p=0.023). Mean scores for perceived usefulness and ease of use of the simulation were good (3.81 and 4.10 on a 5-point scale, respectively). Issues identified in usability testing include confusing interaction with some features, preferences for a more interactive representation of the EMR, and more options for shared decision making. In conclusion, computer-based simulation may be an effective and acceptable tool for teaching residents how to better use EMRs in clinical encounters.
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
Aviv
A
Shachak
Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
Sharon
S
Domb
School of Health Information Sciences, University of Victoria, Victoria, BC, Canada.
Elizabeth
E
Borycki
Faculty of Information, University of Toronto, Toronto, ON, Canada.
Nancy
N
Fong
Faculty of Information, University of Toronto, Toronto, ON, Canada.
Alison
A
Skyrme
School of Health Information Sciences, University of Victoria, Victoria, BC, Canada.
Andre
A
Kushniruk
Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel.
Shmuel
S
Reis
MSR-Israel Center for Medical Simulation, Sheba Medical Center, Tel-Hashomer, Israel.
Amitai
A
Ziv
D002983:Clinical Competence / Q000706:statistics & numerical data*; D003197:Computer Literacy / Q000706:statistics & numerical data*; D003194:Computer-Assisted Instruction / Q000706:statistics & numerical data*; D004521:Educational Measurement / Q000706:statistics & numerical data; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D005194:Family Practice / Q000193:education*; D007396:Internship and Residency / Q000379:methods*; D009864:Ontario; D010865:Pilot Projects