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Development and evaluation of a Health Record Online Submission Tool (HOST).

Wagner DP, Roskos S, Demuth R, Mavis B - Med Educ Online (2010)

Bottom Line: Student perception of grading consistency did not improve.With it we were able to maintain effective instruction, streamline course management, and significantly decrease staff time.HOST did not improve student perception of grading consistency and did not prepare students for specific EHR use.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Office of College-wide Assessment, Michigan State University College of Human Medicine, East Lansing, MI 48824, USA. wagnerd@msu.edu

ABSTRACT

Introduction: Health records (HRs) are crucial to quality patient care. The Michigan State University College of Human Medicine begins teaching health record (HR) writing during the second-year clinical skills courses. Prior to this project, we used a cumbersome paper system to allow graduate assistants to grade and give feedback on students' HRs. This study discusses the development and evaluates the effectiveness of the new Health Record Online Submission Tool (HOST).

Methods: We developed an electronic submission system with the goals of decreasing the logistical demands of the paper-based system; improving the effectiveness, consistency, and oversight of HR instruction and evaluation; expanding the number of students who could serve as written record graduate assistants (WRGAs); and to begin preparing students for the use of electronic health records (EHRs). We developed the initial web-based system in 2003 and upgraded it to its present form, HOST, in 2007. We evaluated the system using course evaluations, surveys of WRGAs and clinical students, and queries of course faculty and staff.

Results: Course evaluation by 1,106 students during years 2001 through 2008 revealed that the students' self-assessment of ability to write HRs improved briefly with the introduction of HOST but then returned to baseline. The initial change to electronic submission was well received, though with continued use its rating dropped. A survey of 65 (response rate 61.3%) clinical students indicated that HOST did not completely prepare them for EHRs. The WRGAs (n = 14; response rate 58%) found the system easy to use to give feedback to students. Faculty (n = 3) and staff (n = 2) found that it saved time and made the review of students' HRs and WRGAs grading simpler. Student perception of grading consistency did not improve.

Conclusions: HOST is the first published online method of in-depth HR training for preclinical students using information gathered in clinical encounters. With it we were able to maintain effective instruction, streamline course management, and significantly decrease staff time. HOST did not improve student perception of grading consistency and did not prepare students for specific EHR use. Within the context of our class size expansion and our community-based educational program, HOST bridges geography and can support future improvements in HR instruction and faculty development. Medical educators at other institutions could use a similar system to accomplish these goals.

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Screen showing portion of completed HR, ready for submission.
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Figure 0001: Screen showing portion of completed HR, ready for submission.

Mentions: In 2003, we converted our ‘Written Record Protocol (WRP) Tutorial’ from paper format to an online, menu-driven application that students accessed via a unique login. In order to maintain patient confidentiality, written records were stored on a dedicated server. When students logged in, the system presented them with a menu of written record assignments. After choosing an assignment, the student would see each section of the assignment as a blank text box (Fig. 1). The system differed significantly from actual EHRs, as it did not include drop-down menus or other cues so that students would be required to develop skills in de novo HR creation. Grading rubrics for each section of the relevant written record assignment appeared below each text box, reinforcing the guidelines in the Written Record Protocol. Students could access links to sections of the WRP from the submission application if desired. The WRGAs could access the system via the Internet in the same way to grade assignments.


Development and evaluation of a Health Record Online Submission Tool (HOST).

Wagner DP, Roskos S, Demuth R, Mavis B - Med Educ Online (2010)

Screen showing portion of completed HR, ready for submission.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2958708&req=5

Figure 0001: Screen showing portion of completed HR, ready for submission.
Mentions: In 2003, we converted our ‘Written Record Protocol (WRP) Tutorial’ from paper format to an online, menu-driven application that students accessed via a unique login. In order to maintain patient confidentiality, written records were stored on a dedicated server. When students logged in, the system presented them with a menu of written record assignments. After choosing an assignment, the student would see each section of the assignment as a blank text box (Fig. 1). The system differed significantly from actual EHRs, as it did not include drop-down menus or other cues so that students would be required to develop skills in de novo HR creation. Grading rubrics for each section of the relevant written record assignment appeared below each text box, reinforcing the guidelines in the Written Record Protocol. Students could access links to sections of the WRP from the submission application if desired. The WRGAs could access the system via the Internet in the same way to grade assignments.

Bottom Line: Student perception of grading consistency did not improve.With it we were able to maintain effective instruction, streamline course management, and significantly decrease staff time.HOST did not improve student perception of grading consistency and did not prepare students for specific EHR use.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine and Office of College-wide Assessment, Michigan State University College of Human Medicine, East Lansing, MI 48824, USA. wagnerd@msu.edu

ABSTRACT

Introduction: Health records (HRs) are crucial to quality patient care. The Michigan State University College of Human Medicine begins teaching health record (HR) writing during the second-year clinical skills courses. Prior to this project, we used a cumbersome paper system to allow graduate assistants to grade and give feedback on students' HRs. This study discusses the development and evaluates the effectiveness of the new Health Record Online Submission Tool (HOST).

Methods: We developed an electronic submission system with the goals of decreasing the logistical demands of the paper-based system; improving the effectiveness, consistency, and oversight of HR instruction and evaluation; expanding the number of students who could serve as written record graduate assistants (WRGAs); and to begin preparing students for the use of electronic health records (EHRs). We developed the initial web-based system in 2003 and upgraded it to its present form, HOST, in 2007. We evaluated the system using course evaluations, surveys of WRGAs and clinical students, and queries of course faculty and staff.

Results: Course evaluation by 1,106 students during years 2001 through 2008 revealed that the students' self-assessment of ability to write HRs improved briefly with the introduction of HOST but then returned to baseline. The initial change to electronic submission was well received, though with continued use its rating dropped. A survey of 65 (response rate 61.3%) clinical students indicated that HOST did not completely prepare them for EHRs. The WRGAs (n = 14; response rate 58%) found the system easy to use to give feedback to students. Faculty (n = 3) and staff (n = 2) found that it saved time and made the review of students' HRs and WRGAs grading simpler. Student perception of grading consistency did not improve.

Conclusions: HOST is the first published online method of in-depth HR training for preclinical students using information gathered in clinical encounters. With it we were able to maintain effective instruction, streamline course management, and significantly decrease staff time. HOST did not improve student perception of grading consistency and did not prepare students for specific EHR use. Within the context of our class size expansion and our community-based educational program, HOST bridges geography and can support future improvements in HR instruction and faculty development. Medical educators at other institutions could use a similar system to accomplish these goals.

Show MeSH