Maria Alcocer Alkureishi1, Wei Wei Lee2, Maureen Lyons3, Kristen Wroblewski4, Jeanne M Farnan2, Vineet M Arora2. 1. Department of Academic Pediatrics, University of Chicago, Chicago, United States. Electronic address: malkureishi@peds.bsd.uchicago.edu. 2. Department of Medicine, University of Chicago, Chicago, United States. 3. Division of General Internal Medicine, Saint Louis University School of Medicine, St. Louis, United States. 4. Department of Public Health Sciences, University of Chicago, Chicago, United States.
Abstract
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 MS3s 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.
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 MS3s 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.
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