title: The Electronic Health Record Objective Structured Clinical Examination: Assessing Student Competency in Patient Interactions While Using the Electronic Health Record.
abstract: Because many medical students do not have access to electronic health records (EHRs) in the clinical environment, simulated EHR training is necessary. Explicitly training medical students to use EHRs appropriately during patient encounters equips them to engage patients while also attending to the accuracy of the record and contributing to a culture of information safety.
  
  
  
  Faculty developed and successfully implemented an EHR objective structured clinical examination (EHR-OSCE) for clerkship students at two institutions. The EHR-OSCE objectives include assessing EHR-related communication and data management skills.
  
  
  
  The authors collected performance data for students (n = 71) at the first institution during academic years 2011-2013 and for students (n = 211) at the second institution during academic year 2013-2014. EHR-OSCE assessment checklist scores showed that students performed well in EHR-related communication tasks, such as maintaining eye contact and stopping all computer work when the patient expresses worry. Findings indicated student EHR skill deficiencies in the areas of EHR data management including medical history review, medication reconciliation, and allergy reconciliation. Most students' EHR skills failed to improve as the year progressed, suggesting that they did not gain the EHR training and experience they need in clinics and hospitals.
  
  
  
  Cross-institutional data comparisons will help determine whether differences in curricula affect students' EHR skills. National and institutional policies and faculty development are needed to ensure that students receive adequate EHR education, including hands-on experience in the clinic as well as simulated EHR practice.
authors.affiliation: F.E. Biagioli is professor of family medicine, Oregon Health & Science University, Portland, Oregon. D.L. Elliot is professor, Division of Health Promotion & Sports Medicine, Oregon Health & Science University, Portland, Oregon. R.T. Palmer is assistant professor, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon. C.C. Graichen is a 2016 graduate, Oregon Health & Science University, Portland, Oregon. R.E. Rdesinski is research associate, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon. K.A. Kumar is distinguished teaching professor and vice chair of medical student education, Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas. A.B. Galper is research assistant, Department of Family Medicine, Oregon Health & Science University, Portland, Oregon. J.W. Tysinger is distinguished teaching professor and vice chair of professional development, Department of Family & Community Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Frances E
authors.initials: FE
authors.lastname: Biagioli
authors.forename: Diane L
authors.initials: DL
authors.lastname: Elliot
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Palmer
authors.forename: Carla C
authors.initials: CC
authors.lastname: Graichen
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Rdesinski
authors.forename: Kaparaboyna
authors.initials: K
authors.lastname: Ashok Kumar
authors.forename: Ari B
authors.initials: AB
authors.lastname: Galper
authors.forename: James W
authors.initials: JW
authors.lastname: Tysinger
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D003142:Communication; D003479:Curriculum; D004501:Education, Medical / Q000592:standards*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D010808:Physical Examination / Q000523:psychology*; D010817:Physician-Patient Relations; D017410:Practice Guidelines as Topic / Q000592:standards; D013337:Students, Medical / Q000523:psychology*; D013663:Teaching / Q000592:standards*; D014481:United States