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Abstract Introduction Trainees from the millennial generation are adopting technology at a faster rate than their senior counterparts. Technology adoption in health care is also being fueled by national policies such as the sharp rise in electronic medical record (EMR) use after President Obama's 2009 health care stimulus package. Nonetheless, there is very little curricular focus addressing patient-centered use of technology. Abraham Verghese has drawn attention to the unfortunate practice of focusing on the “iPatient,” who exists only on the computer screen as a set of data points, while ignoring the real patient. Methods Our resource provides a framework for educators to teach learners of various levels (students, residents, fellows, and attendings) how technology use (e.g., EMRs and tablet computers) can affect patient-doctor communication in both the inpatient and outpatient settings. The resource includes a PowerPoint lecture on patient-centered EMR use and best practices; two teaching videos of a less-than-ideal and a more-ideal patient-provider interaction, along with an accompanying worksheet; pocket cards to summarize best practices for patient-centered technology use in both outpatient and inpatient settings; resource files for implementing the patient-centered EMR-use objective structured clinical exam (OSCE), including iPaCT Curriculum; overview and description, standardized patient (SP) guide, and door chart for active experimentation; and an e-CEX evaluation tool for use during the OSCE as well as for direct observation. The lecture, OSCE, and feedback take about 90 minutes. Results We implemented this patient-centered EMR-use curriculum with second-year students at the University of Chicago Pritzker School of Medicine. To date, we have results only for our second-year students, with our third-years (who did not receive the lecture but did participate in the same OSCE and evaluation) as a comparison controls. For these two groups, we demonstrated statistically significant improvement in SP evaluation OSCE performance scores of second-years who received this curriculum as compared to third-years who did not. We also demonstrated statistically significant improvement on second-year scores on a post-OSCE survey assessing self-perceived knowledge, attitude, and skills. Discussion We first started our curriculum in 2013 with second-year students, but we have since expanded it to internal medicine residents and will be also including faculty (of various disciplines). The curriculum can help train learners of all levels to promote and maintain patient-centered care in the context of EMR use. Furthermore, the e-CEX evaluation tool can help programs monitor the quality of patient-centered technology use and identify areas for improvement. |
