Where's the EHR? Student access to medical records
The title of a recent article puts it bluntly: "Are med schools failing future docs?"
The article, published in Healthcare IT News, explores the lack of training in electronic health records received by medical students. According to the article, "Many medical students have never even had the chance to make a note in an EHR, even though the technology will be inextricable from the way they'll practice…"
In fact, the article notes, a recent study "found that just 64 percent of med school programs allowed future docs any use of electronic records; of those that do, only two-thirds allowed students to actually write notes within the EHR."
In 2011, recognizing this issue as a growing concern, the AMA Council on Medical Education developed a report (PDF) focusing on medical student access to EHRs that was subsequently approved as AMA policy. The policy notes that the AMA "recognizes the educational benefits of medical student access to electronic health record (EHR) systems" and "encourages medical schools, teaching hospitals, and physicians practices used for clinical education to utilize clinical information systems that permit students to both read and enter information into the EHR, as an important part of the patient care team contributing clinically relevant information."
The report also encouraged research into methods "to overcome barriers and facilitate appropriate medical student access to EHRs."
The need for such exposure early in the medical education continuum is echoed by the results of a new study, which found that EHRs are a significant barrier to physicians' professional satisfaction. The RAND Corporation study, sponsored by the AMA, found that:
- Current technology interferes with face-to-face discussions with patients.
- Physicians are spending too much time on clerical work.
- The "temptation of templates" is degrading the accuracy of medical records.
- EHR systems are more costly than anticipated and do not interact with other EHR systems.
The study is the first step in the AMA's strategic initiative to enhance practice sustainability and professional satisfaction through effective care delivery and payment models. Learn more about this and the AMA's other two strategic focus areas, accelerating change in medical education and improving health outcomes.
Med schools outline ideas to change education
At a recent AMA conference, key leaders in medical education shared ideas and innovations to bring education of tomorrow's physicians fully into the 21st Century.
Among conference participants were representatives of the 11 medical schools selected to receive $1 million grants from the AMA for projects to accelerate change in medical education. In a session led by Mark Quirk, vice president of Medical Education Outcomes at the AMA, these experts discussed some of the challenges to change that must be overcome.
As outlined by Quirk, the current culture of medical education is still mostly focused on knowledge acquisition, with the system of evaluation largely defining what is being taught. Other barriers cited by session participants included the attitudes of the faculty and an "almost slavish dedication to their content expertise," along with ever-present and rising financial pressures.
What is needed, at root, noted one participant, is to "[change] the conversation about medical education from something that is considered as a burden and a cost to something that is really seen as an essential driver in health care transformation."
Another large-scale challenge outlined was how to ensure "authentic" learning that is fully integrated into patient care—an immersive learning experience from day one of medical school. One participant called for medical education to "stop talking to people who look like us" and bring in other disciplines, from engineering to nursing, to provide "truly authentic, diverse learning experiences."
Part of the problem is a risk-averse culture—among both students and schools alike. "[Students] need feedback that is constant, ongoing, repetitive, low-stakes—so they don't fear the immersion." And medical schools must have "the courage to allow our students to actually be in the clinical settings, actually access and use our electronic medical records and for them to demonstrate and participate in the skills we're expecting them to become expert in."
UIC College of Medicine wins latest Event of the Month award
The University of Illinois (UIC) College of Medicine in Chicago is the latest winner of the AMA Medical Student Section's (MSS) "Event of the Month" award, which showcases recruitment, community service, education and AMA-MSS National Service Project events coordinated by individual AMA medical student sections.
UIC won for their “Health care reform debate” event held in September, which featured four distinguished speakers: Robert Wah, MD; Claudia Fegan, MD; William Werner, MD; and Ram Krishnamoorthi, MD. The debate focused on what has happened in health care reform, reforms the system still needs, and the best way to educate medical students on reform and the health care system throughout their careers.
This educational event was open to medical students, residents and faculty of UIC as well as the public, providing an opportunity to learn more about health care reform. The AMA provided funding for dinner at the event.
Is your AMA medical student section holding similar events? When you request a grant through the AMA Section Involvement Grant (SIG) program, you automatically are eligible for the "Event of the Month" award, which the AMA selects each month. At the end of the school year, all monthly awards will be showcased in June at the AMA-MSS Annual Assembly Meeting and be voted on by students for one "Event of the Year" winner.
Through the SIG program, the AMA-MSS provides an opportunity for local AMA medical student sections to:
- Educate students about the AMA and provide an opportunity for students to get more involved.
- Help put AMA policy into action by providing a service to medical school campuses or communities.
- Engage in activities that focus on AMA's top priorities.
News and notes
- Medical student research grants available via the AMA Foundation—apply now.
- Are medical students prepared to care for patients with obesity? (Time).
- New Jersey offers loan forgiveness to physician grads to keep them in-state (NJ.com).
- LCME's proposed standards aim to simplify accreditation while ensuring public safety and student advocacy (AAMC Reporter).
- University of Texas Health Science Center at San Antonio regains full LCME accreditation after two-year stint on probation (San Antonio Express News).
AMA resources for medical schools and students
- Mentor students, residents and fellows via AMA program.
- Learn about the AMA Medical Student Section.
- Learn about the AMA Section on Medical Schools.
- Learn about the AMA Council on Medical Education.
- Follow the AMA professional ethics Twitter page, and look for the #MedEdAMA hashtag for tweets on the AMA's Twitter page about medical education.