TY - JOUR
T1 - Electronic-clinical evaluation exercise (e-CEX)
T2 - A new patient-centered EHR use tool
AU - Alkureishi, Maria Alcocer
AU - Lee, Wei Wei
AU - Lyons, Maureen
AU - Wroblewski, Kristen
AU - Farnan, Jeanne M.
AU - Arora, Vineet M.
N1 - Funding Information:
Funding for this work was made possible by grants from the Alliance for Academic Internal Medicine and Clerkship Directors of Internal Medicine iInTime Small Grants Program to Promote Educational Scholarship (Grant number FP058012-01), the University of Chicago Academy of Distinguished Medical Educators Medical Education Grants Program (Grants number DD45671 and DD35051), and theArnold P. Gold Foundation Research Institute “Mapping the Landscape, Journeying Together” Project (Grant number CH-13-004).
Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/3
Y1 - 2018/3
N2 - Introduction: Electronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool. Methods: Electronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed. Results: Three investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach's alpha = 0.89). MS2s scored significantly higher than untrained MS3 s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P = 0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation = 0.74, P < 0.001), providing concurrent validity evidence. Item reduction suggested a three-item tool had similar explanatory power (R-squared = 0.85 vs 0.86). Conclusion: e-CEX is a reliable, valid tool to assess medical student patient-centered EHR communication skills. Practice implications: While validation is needed with other healthcare providers, e-CEX may help improve provider behaviors and enhance patients’ overall experience of EHR use in their care.
AB - Introduction: Electronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool. Methods: Electronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed. Results: Three investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach's alpha = 0.89). MS2s scored significantly higher than untrained MS3 s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P = 0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation = 0.74, P < 0.001), providing concurrent validity evidence. Item reduction suggested a three-item tool had similar explanatory power (R-squared = 0.85 vs 0.86). Conclusion: e-CEX is a reliable, valid tool to assess medical student patient-centered EHR communication skills. Practice implications: While validation is needed with other healthcare providers, e-CEX may help improve provider behaviors and enhance patients’ overall experience of EHR use in their care.
KW - Communication
KW - EHR
KW - Electronic health records
KW - Electronic medical records
KW - Evaluation
KW - Patient-provider relationship
UR - http://www.scopus.com/inward/record.url?scp=85031403669&partnerID=8YFLogxK
U2 - 10.1016/j.pec.2017.10.005
DO - 10.1016/j.pec.2017.10.005
M3 - Article
C2 - 29042145
AN - SCOPUS:85031403669
VL - 101
SP - 481
EP - 489
JO - Patient Education and Counseling
JF - Patient Education and Counseling
SN - 0738-3991
IS - 3
ER -