Trial reportJournal of the American Medical Informatics Association : JAMIA2015
Effects of electronic health record use on the exam room communication skills of resident physicians: a randomized within-subjects study.
Trial report in Journal of the American Medical Informatics Association : JAMIA, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Developing an evidence base of best practices for integrating computerized systems into the exam room: a systematic review.Journal of the American Medical Informatics Association : JAMIA · 2017Pooled it
- Article
- Implementing Precision Medicine and Artificial Intelligence in Plastic Surgery: Concepts and Future Prospects.Plastic and reconstructive surgery. Global open · 2019Article
- Clinically Excellent Use of the Electronic Health Record: Review.JMIR human factors · 2018Review
- Use of electronic medical records and quality of patient data: different reaction patterns of doctors and nurses to the hospital organization.BMC medical informatics and decision making · 2017Article
- How organizational escalation prevention potential affects success of implementation of innovations: electronic medical records in hospitals.Implementation science : IS · 2016Article
- Trends in public perceptions of electronic health records during early years of meaningful use.The American journal of managed care · 2015Article
- Careful experiments advance the science of informatics.Journal of the American Medical Informatics Association : JAMIA · 2015Article
- Paper versus EHR: simplistic comparisons may not capture current reality.Journal of the American Medical Informatics Association : JAMIA · 2015Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundThe effects of electronic health records (EHRs) on doctor-patient communication are unclear.
objectiveTo evaluate the effects of EHR use compared with paper chart use, on novice physicians' communication skills.
designWithin-subjects randomized controlled trial using observed structured clinical examination methods to assess the impact of use of an EHR on communication.
settingA large academic internal medicine training program. POPULATION: First-year internal medicine residents.
interventionResidents interviewed, diagnosed, and initiated treatment of simulated patients using a paper chart or an EHR on a laptop computer. Video recordings of interviews were rated by three trained observers using the Four Habits scale.
resultsThirty-two residents completed the study and had data available for review (61.5% of those enrolled in the residency program). In most skill areas in the Four Habits model, residents performed at least as well using the EHR and were statistically better in six of 23 skills areas (p<0.05). The overall average communication score was better when using an EHR: mean difference 0.254 (95% CI 0.05 to 0.45), p = 0.012, Cohen's d of 0.47 (a moderate effect). Residents scoring poorly (>3 average score) with paper methods (n = 8) had clinically important improvement when using the EHR. LIMITATIONS: This study was conducted in first-year residents in a training environment using simulated patients at a single institution.
conclusionsUse of an EHR on a laptop computer appears to improve the ability of first-year residents to communicate with patients relative to using a paper chart.
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