P0032 - The Epic Learning Experience: Medical Student Feedback on How to Introduce the Electronic Medical Record

Introduction: Electronic medical record (EMR) systems have rapidly become an essential component of medical care. Currently, 87% of physicians use these systems compared to 35% a decade ago. Evidence-based approaches to EMR training during medical education that reduce the cognitive load of learners are important.

Objective: By surveying medical students currently learning to use EpicTM EMR, we aim to understand their experience and their suggestions of how best to approach EMR skill building.

Methods: In April 2019, two rotations into the first clinical year, a class of 156 medical students was asked to complete a 20-question multiple choice and free response survey regarding their experience learning to use Epic EMR.

Results: Twenty (13%) of the students completed the survey. Regarding their experience, 2/3 of the respondents recalled having been somewhat (47%) or completely (18%) overwhelmed by Epic during their first two weeks on clinical rotations. 43% reported receiving less than 15 minutes of Epic-based assistance and 65% felt the amount of instruction was insufficient. Half recalled receiving assistance primarily from their intern, followed by medical student peers (25%), attendings (14%), and senior residents (7%). Regarding feedback from student respondents, suggestions for new skill-building methods were varied: 68% preferred a longitudinal learning approach—either during their pre-clinical years (26%) or over the course of their first clinical year (42%). 60% preferred an intern-led EMR skills teaching, versus 53% a 4th year medical student-led teaching, 33% a senior resident-led teaching, and 13% an attending-led teaching. Over 80% of the students requested expanding the curriculum to include pre-rounding, smart phrases, and understanding the intern EMR workflow. The most common requests included a self-learning checklist (72%) and 10 minutes of protected time with a resident to focus on the EMR upfront (72%).

Conclusion: Current medical student introduction to Epic EMR is insufficient and stressful for medical students. New approaches that decrease cognitive load and improve learner wellbeing are needed and currently under investigation in the form of a quality improvement project.