Electronic Health Record in medical education: perceptions of teachers and preceptors

Abstract: Introduction: The implementation of the Electronic Health Record (EHR) in hospital teaching units has promoted the integration of Health Information Technology (HIT) into medical education and clinical practice. Objective: The study analyzed teachers and preceptors’ perceptions about the integration of EHR in curricular practices at a public university. Method: A qualitative study, in which data was collected through semi-structured interviews with six medical professors and four preceptors. The study adopted as categories of analysis the domains of competences and learning results from the use of EHR, identified and improved in a British multicenter study (Digital Health, Data Access and Generation, Communication, Multiprofessional Work, Accompaniment and Monitoring). A new category entitled “Pedagogical Issues”, was included to stimulate subjects’ reflections on their pedagogical practices with the EHR. Thematic content analysis was used for data analysis. Results: Teachers and preceptors agree that students need formal guidance on how to use HIT in their educational and professional development, and to preserve the secrecy and confidentiality of information during patient care using the EHR. For them, the use of decision support systems associated with EHR contributes to the teaching-learning process, in addition to allowing greater visibility of information from other health professionals, and facilitates student access to patients’ clinical data. EHR is a support tool that has the potential to promote the use of active methodologies, to contextualize teaching, to provide student autonomy and authorship, and to instigate them in the search for knowledge. Conclusion: HIT curricular integration has been pointed out as a way for students to develop clinical competences and skills, when using EHR in their clinical practice units.

摘要：
引言：电子健康档案（Electronic Health Record）在医院教学单元中的应用，推动了健康信息技术（Health Information Technology）与医学教育及临床实践的深度融合。
研究目的：本研究旨在分析某公立大学的教师与临床带教者对在课程实践中整合EHR的认知态度。
研究方法：本研究为质性研究，通过半结构化访谈收集数据，访谈对象包括6名医学教授及4名临床带教教师。本研究采用英国多中心研究中确定并优化的EHR使用能力与学习成果领域作为分析类别，涵盖数字健康、数据获取与生成、沟通、多专业协作、照护与监测。本研究新增“教学议题”这一分析类别，以引导受访对象反思其在EHR应用中的教学实践。数据分析采用主题内容分析法。
研究结果：教师与临床带教者均认为，学生需接受正式指导，以掌握如何在教育与职业发展中运用HIT，并学会在使用EHR开展患者照护时保障信息的保密性。他们认为，与EHR联用的决策支持系统不仅有助于教学过程，还能提升其他医疗专业人员的信息可见度，并便利学生获取患者临床数据。EHR作为辅助教学工具，具备推动主动式教学法应用、实现教学情境化、培养学生自主性与临床文档撰写能力，以及激发其知识探索热情的潜力。
研究结论：研究指出，将健康信息技术融入课程体系，可助力学生在临床实践单元中使用EHR，从而培养临床能力与专业技能。