512 - Seeking Education; Exploring Resident and Attending Perception of Education through Medical Documentation in the EHR.

Poster Number: 512
Publication Number: 512.423

Arica Gregory, Medical University of South Carolina, Charleston, SC, United States; Mason Walgrave MD, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Daniel Williams, Medical University of South Carolina, Charleston, SC, United States

Background: With universal adoption of electronic health records (EHR) at academic medical institutions, its impact on medical education is potentially large but not clearly defined. Studies have examined the EHR as a tool for assessment of knowledge, however, limited exploration into using the EHR as a primary educational tool has been conducted, despite education in the EHR being very important among supervising attendings.1

Objective: To explore resident and faculty perceptions of medical documentation within the EHR as a contributor to medical education.

Design/Methods: Using a grounded theory approach, an interview protocol was developed based on expert discussion and a literature review. The script was pilot tested with follow-up analysis to determine the effectiveness and preliminary theoretical sampling as well as to develop a code book. A purposive sampling strategy was used to approach pediatric and medicine-pediatrics (Med-Peds) residents and faculty to match the diversity of resident genders, ethnicities, and training level. Interviews were transcribed using Microsoft Teams and four investigators conducted coding of transcripts. Data analysis proceeded by theoretical sampling and iterative analysis was conducted at regular intervals during the duration of the study.

Results: Thematic saturation was reached with 22 participants; 15 residents and 7 attendings. Of the residents interviewed 6 were PGY1, 5 were PGY2, and 4 were either PGY 3 or PGY4 and 60% were female. Attendings interviewed were 42% female. Five major themes emerged based on code frequency for both residents and attendings including; Medical documentation serves to communicate, writing medical documentation builds skills, reviewing patient notes and charts can build knowledge and accurate resident assessment; problems with EHR waste and efficiency detract from the educational value, and culture of documentation affects education.

Conclusion(s): As trainees spend large portions of time in the EHR and training institutions have reached near-universal adoption of EHRs, efforts to examine not just the assessment potential of documentation and EHR use, but also educational value and opportunity need to be explored. When interviewed, resident and attending groups noted very similar themes suggesting that there is some level of agreement about where educational value comes from and where the EHR as an educational tool can be easily optimized.