"EMERGing" Electronic Health Record Data Metrics: Insights and Implications for Assessing Residents' Clinical Performance in Emergency Medicine.
Journal
AEM education and training
ISSN: 2472-5390
Titre abrégé: AEM Educ Train
Pays: United States
ID NLM: 101722142
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
04
05
2020
revised:
02
07
2020
accepted:
07
07
2020
entrez:
26
4
2021
pubmed:
27
4
2021
medline:
27
4
2021
Statut:
epublish
Résumé
Competency-based medical education requires that residents are provided with frequent opportunities to demonstrate competence as well as receive effective feedback about their clinical performance. To meet this goal, we investigated how data collected by the electronic health record (EHR) might be used to assess emergency medicine (EM) residents' independent and interdependent clinical performance and how such information could be represented in an EM resident report card. Following constructivist grounded theory methodology, individual semistructured interviews were conducted in 2017 with 10 EM faculty and 11 EM residents across all 5 postgraduate years. In addition to open-ended questions, participants were presented with an emerging list of EM practice metrics and asked to comment on how valuable each would be in assessing resident performance. Additionally, we asked participants the extent to which each metric captured independent or interdependent performance. Data collection and analysis were iterative; analysis employed constant comparative inductive methods. Participants refined and eliminated metrics as well as added new metrics specific to the assessment of EM residents (e.g., time between signup and first orders). These clinical practice metrics based on data from our EHR database were organized along a spectrum of independent/interdependent performance. We conclude with discussions about the relationship among these metrics, issues in interpretation, and implications of using EHR for assessment purposes. Our findings document a systematic approach for developing EM resident assessments, based on EHR data, which incorporate the perspectives of both clinical faculty and residents. Our work has important implications for capturing residents' contributions to clinical performances and distinguishing between independent and interdependent metrics in collaborative workplace-based settings.
Identifiants
pubmed: 33898906
doi: 10.1002/aet2.10501
pii: AET210501
pmc: PMC8052996
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e10501Informations de copyright
© 2020 by the Society for Academic Emergency Medicine.
Références
Nurse Res. 2006 Jul 1;13(4):84
pubmed: 27702218
Med Educ. 2018 Apr 19;:
pubmed: 29676054
J Grad Med Educ. 2017 Jun;9(3):361-365
pubmed: 28638518
Acad Med. 2019 May;94(5):671-677
pubmed: 30720528
JAMA. 2009 Sep 23;302(12):1277-83
pubmed: 19773562
Med Educ. 2017 Jan;51(1):40-50
pubmed: 27981658
Risk Manag Healthc Policy. 2011;4:47-55
pubmed: 22312227
J Grad Med Educ. 2017 Dec;9(6):714-715
pubmed: 29270259
Med Care Res Rev. 2010 Oct;67(5):503-27
pubmed: 20150441
Acad Med. 2018 Jun;93(6):826-828
pubmed: 29443719
JAMA Surg. 2015 Aug;150(8):813-4
pubmed: 26083420
Acad Med. 2017 Jun;92(6):752-758
pubmed: 28557934
Med Teach. 2016 Jul;38(7):639-41
pubmed: 27092732
Methods Inf Med. 2010;49(4):320-36
pubmed: 20603687
Am J Med Qual. 2014 Jul-Aug;29(4):292-9
pubmed: 24006028
Acad Med. 2020 Jul;95(7):1014-1019
pubmed: 31833856
Acad Med. 2018 Jun;93(6):833-834
pubmed: 29538103
Acad Med. 2019 Jun;94(6):853-860
pubmed: 30844936
Acad Med. 2015 Nov;90(11):1541-6
pubmed: 25901877
Med Educ. 2020 Aug;54(8):738-747
pubmed: 32119151
Adv Health Sci Educ Theory Pract. 2014 Aug;19(3):435-56
pubmed: 23892689
J Grad Med Educ. 2017 Feb;9(1):109-112
pubmed: 28261404
J Gen Intern Med. 2017 Aug;32(8):935-939
pubmed: 28321550
AEM Educ Train. 2018 Aug 16;2(4):269-276
pubmed: 30386836