Introduction to the Electronic Medical Record: Impact of a Preclerkship Curriculum

Meeting: Hospital Medicine 2012, April 1-4, San Diego, Calif.

Abstract number: 97726


Electronic Medical Record (EMR) systems are becoming more prevalent in clinical settings. However, students generally receive little formal instruction regarding effective use of the EMR during their undergraduate medical training. Since the implementation of an EMR system at our institution, faculty have observed clerkship students spending an increasingly disproportionate amount of time on patient documentation and data review due to prior unfamiliarity with EMR systems.


To determine whether implementation of a pre–clerkship curriculum in use of EMR increase confidence and competence in medical students entering clerkships.


We developed a pre–clerkship curriculum, entitled “Introduction to the Electronic Medical Record,” that students completed during the Transition to Clerkships course in 2011. The purpose of the curriculum was to provide a better student understanding of how to incorporate EMR data into interviewing, clinical reasoning, patient documentation and clinical presentations. We also sought to increase awareness of some unintended but common consequences of adopting EMR into clinical practice by allowing students to interface with an EMR system without affecting real patients. Students participated in a combination of didactic content and clinical reasoning exercises utilizing our institution’s EMR computerized training environment called EPIC Playground. Using an online survey tool, 75/86 students (87% response rate) ranked the overall value of the session at 4.30 (5–point Likert Scale 1 to 5, with 5 as the highest rating). Students also stated that expanding the pre–clerkship EMR curriculum would better prepare them for their clerkships (4.60 on 5–point Likert Scale). Students retrospectively rated their confidence before and after the session in five domains: (1) understanding forms of medical documentation and basic EMR organization, (2) ability to efficiently incorporate EMR into the workflow of evaluating a new patient, (3) ability to navigate the EMR and filter non–essential information, (4) ability to utilize the EMR to complement history–taking and incorporate data to augment clinical reasoning, and (5) appreciation of potential pit–falls of EMR such as auto–population, templates, cut/paste, and propagation of misinformation. Increases in confidence were found to be highly significant (P < 0.0001) in all five domains.


Previously, students received little EMR training prior to clerkships, resulting in low confidence scores in EMR skills. Students felt significantly more confident with their ability to navigate medical records and integrate EMR into their work flow with the introduction of an EMR curriculum. Students highly valued the presence of an EMR curriculum in preparation for clerkships and universally asked for earlier and increased exposure to EMR systems during their pre–clerkship training.

HCAHPS Scores – Project BOOST Pilot Unit.

To cite this abstract:

Braddock C, Chi J, Kugler J, Hooper K, Basaviah P, Oskotsky T. Introduction to the Electronic Medical Record: Impact of a Preclerkship Curriculum. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97726. Journal of Hospital Medicine. 2012; 7 (suppl 2). Accessed April 8, 2020.

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