Sometimes it’s What Not to Teach
When we first started talking with the Indiana University School of Medicine (IUSM) about what lessons they planned on teaching with the RECL Platform (formerly the tEMR application), we had no concept of what could be taught. After all, there are a lot of variables to take into account. Items such as the complexity of the subject matter in comparison to the year of the student, the historical knowledge of the student from previous classes, familiarity with EHR’s from job shadowing opportunities, the experience and background of the individual educators, and the list goes on. The good news is we had leaders and pioneers in medical education on our side to help guide us, which was definitely of great help. I quickly forgot that no one had tried to create a teaching tool for EHR’s at this level of detail before, not at our university, and in most cases, not nationally.
So, what began as a prearranged list of lessons with objectives, were just that, a bunch of great ideas of topics and goals that were based on what a medical student should know. The concept of how to teach those topics and goals with an EHR was entirely foreign, and no we are not talking about cute, friendly aliens. We are talking about the kind that has a mysterious green glow, walk slowly and look at you curiously. In the end, we found our goals lofty, to say the least. Some topics were completely unrealistic to teach in 2 hours a week for 12 weeks. For other topics, the problem then became to how to teach them with the RECL Platform (formerly tEMR) at all?
A list of common questions that occur during lesson building sessions are these:
- Is the point to use the RECL Platform (formerly tEMR) to teach the lesson objectives?
- Or is the lesson objective the point to the session? And if we can use the RECL Platform (formerly tEMR) to do it better, shouldn’t we do that?
- Should the EHR be used as a simulator where you interact with it by entering notes, prescribing orders, checking for allergies and observations while utilizing clinical decision support to help guide your decisions?
- Or should it be a chart repository that you can data mine what you need, to complete an essay or worksheet for class? Should it be both?
- What topics are right up the alley to be taught with an EHR versus ones that should be taught without? (a.k.a. old school)
We are very much still learning these lessons ourselves.
Lots of questions above, what do you think? What are the first things you believe someone learning an EHR should know?
Remember to think clinically as well as technically. What are the topics that are just too broad or complicated to teach using an EHR? Before your first experience with an EHR, what do you wish you knew?
I’m looking forward to reading your comments below.
Project Manager for the Regenstrief EHR Clinical Learning Platform (formerly the Teaching EMR)