Use of Simulated EHR Cases for Medical Student Education on CDS

May 21, 2018 2:00 PM – 3:30 PM

Ashwini Davison, Johns Hopkins School of Medicine

Medical students in the post-HITECH era are provided with exposure to electronic health records (EHRs) in a variety of didactic and clinical settings. There is no consensus approach regarding how medical students should be taught about clinical decision support (CDS). In 2014, Hersh et al published a set informatics competencies for medical students, with recommendations on when to start teaching certain skills. One of the early learning objectives is the ability to recognizing different types of CDS. At Johns Hopkins School of Medicine, 1st year medical students who take a 4-day elective on informatics are taught about different types of CDS via a multi-modal approach that includes lectures, readings, and interactive exercises in a simulated EHR environment. Simulated patient cases with instructional worksheets have been developed to provide students with practical experiences with different forms of clinical decision support including health maintenance reminders, best practice advisories (BPAs), medication alerts, and order sets. Students login to faculty-developed cases and gain experience in distinguishing between examples of active vs passive CDS in the simulated patient chart. Students are prompted to take actions that generate both interruptive and non-interruptive alerts. When writing orders that generate alerts, students have to identify whether there is a hard-stop or a soft-stop. They also gain experiencing in critiquing the existing logic behind the alerts using the 2015 ASHP guidelines on essential CDS capabilities. During the 2018 course, structured data will be collected for purposes of assessment.