AMA: Medical students, residents receive insufficient EHR training

Medical students and residents are not effectively using electronic health records because they continue to receive insufficient training on the systems as part of their formal professional education.

That’s the contention of the American Medical Association, whose policymaking body—AMA’s House of Delegates—met this week at its annual meeting and adopted a new policy that encourages medical schools and residency programs to “design clinical documentation and electronic health records (EHR) training that provides evaluative feedback regarding the value and effectiveness of the training, and, where necessary, make modifications to improve the training.”

In addition, the nation’s largest physician group wants to see medical schools and residency programs “provide clinical documentation and EHR training that can be evaluated and demonstrated as useful in clinical practice” and to “provide EHR professional development resources for faculty to assure appropriate modeling of EHR use during physician-patient interactions.”

These directives to take action are in response to a damning report by AMA’s Council on Medical Education which documented “widespread concerns” regarding the quality of clinical documentation training provided to medical students and residents.

“Medical students’ inconsistent access to the EHR can result in students graduating without well- developed skills, forcing first-year residents to spend time familiarizing themselves with the EHR while they are learning to care for patients for the first time without direct supervision,” charges the report. “Although the medical education community agrees that it is essential for students to become familiar with documentation and the EHR, some institutions restrict access to the EHR because of potential legal liability related to the risk of errors made by students’ ability to copy and paste notes in the EHR.”

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Susan Skochelak, MD, vice president for medical education at the AMA, says the problem with EHR training for medical students and residents is that most of the current teaching is focused on compliance with regulations such as HIPAA.

While those are important areas of the curriculum, she contends, it’s equally important to make medical students and residents comfortable with EHRs—tools that doctors will be using every day of their professional lives.

The AMA wants physicians in training to “feel comfortable” with the technology and “understand how to make it their own, rather than have it be a barrier to patients care,” adds Skochelak, who notes that under the AMA’s Accelerating Change in Medical Education initiative, a consortium of medical schools are developing a new curriculum to transform the way doctors are trained.

So far, the AMA has awarded $12.5 million in grants to 32 U.S. medical schools to develop innovative curricula that can ultimately be implemented at institutions across the country. Those schools that are revamping education are already supporting training for an estimated 19,000 medical students.

“We’re starting to think about what would a national curriculum in this area look like for medical students and residents, because no one’s really sat down and thought through what really should be included,” Skochelak says.