# Impact of Electronic Medical Record Training on Pediatric Residents’ Learning Outcomes: A Simulation-Based Study

## TL;DR

This study shows that training pediatric residents with electronic medical records in simulations improves their EMR skills and possibly their clinical decisions.

## Contribution

The study introduces a simulation-based approach to EMR training for pediatric residents and evaluates its impact on learning outcomes.

## Key findings

- Residents in the intervention group showed significant improvement in EMR proficiency scores in both sepsis and respiratory cases.
- Simulation performance improved slightly in both groups, but the differences were not statistically significant.
- The study highlights the potential of simulation-based EMR training to enhance clinical decision-making skills.

## Abstract

Objective

The objective of this study is to evaluate the impact of electronic medical record (EMR) training on pediatric residents' EMR proficiency and clinical decision-making in a simulated setting.

Methods

This was a prospective, non-blinded randomized controlled trial. Residents randomized into control and intervention groups participated in baseline simulated sepsis and respiratory distress scenarios. The intervention group received structured debriefing followed by EMR training relevant to the sepsis scenario, while the control group received the same debriefing without EMR training. The respiratory case was not debriefed. All residents participated in follow-up simulations three to six months later. The primary outcome was the change in the EMR proficiency score from baseline to follow-up as measured by an explicit checklist. The secondary outcome was residents' clinical decision-making in a simulated setting as measured by an intervention checklist.

Results

Twenty-eight residents completed the study. In the sepsis case, there was a significant improvement of 2.9 points (95% CI: 1.6, 4.2) in the intervention group EMR score, and a non-significant improvement in the control group. In the respiratory case, there was also a significant improvement of 3 points (95% CI: 1.7, 4.3) in the intervention group EMR score, and a non-significant improvement in the control group. For simulation performance, there was a non-significant improvement in both the intervention and control groups of 1.44 points (95% CI: -0.1, 2.9) and 0.77 points (95% CI: -0.7, 2.3) for the sepsis case, respectively. In the respiratory case, there was an improvement of 0.77 points (95% CI: 0.09, 1.5) in the intervention group and an improvement of 0.5 points (95% CI: -1.8, 1.2) in the control group.

Conclusion

Simulation-based EMR training can significantly improve EMR data gathering skills and may enhance clinical decision-making in a simulated environment. These results are limited by this study being a single-center and based on the local EMR, as this may impact generalizability.