Evidence map›Paper›PMID 32214333›Full record

Trial reportPloS one2020

Electronic charts do not facilitate the recognition of patient hazards by advanced medical students: A randomized controlled study.

Friederike Holderried, Anne Herrmann-Werner, Moritz Mahling, Martin Holderried, Reimer Riessen, Stephan Zipfel, Nora Celebi

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 97% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Friederike HolderriedDepartment of Anaesthesiology, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany.
Anne Herrmann-WernerDepartment of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Baden-Württemberg, Tübingen, Germany.
Moritz MahlingDepartment of Diabetology, Endocrinology, Nephrology, Section of Nephrology and Hypertension, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany.ORCID 0000-0001-7960-4015
Martin HolderriedDepartment of Quality Management, Medical and Business Development, University Hospital of Tübingen, Tübingen, Baden-Württemberg, Germany.
Reimer RiessenDepartment of Internal Medicine VIII, Intensive Care Unit, University Hospital Tübingen, Tübingen, Baden-Württemberg, Germany.
Stephan ZipfelDepartment of Internal Medicine VI, Psychosomatic Medicine, University Hospital Tübingen, Baden-Württemberg, Tübingen, Germany.
Nora CelebiPHV Dialysis Center Waiblingen, Waiblingen, Germany.
University Children's Hospital Tübingen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chart review is an important tool to identify patient hazards. Most advanced medical students perform poorly during chart review but can learn how to identify patient hazards context-independently. Many hospitals have implemented electronic health records, which enhance patient safety but also pose challenges. We investigated whether electronic charts impair advanced medical students' recognition of patient hazards compared with traditional paper charts. Fifth-year medical students were randomized into two equal groups. Both groups attended a lecture on patient hazards and a training session on handling electronic health records. One group reviewed an electronic chart with 12 standardized patient hazards and then reviewed another case in a paper chart; the other group reviewed the charts in reverse order. The two case scenarios (diabetes and gastrointestinal bleeding) were used as the first and second case equally often. After each case, the students were briefed about the patient safety hazards. In total, 78.5% of the students handed in their notes for evaluation. Two blinded raters independently assessed the number of patient hazards addressed in the students' notes. For the diabetes case, the students identified a median of 4.0 hazards [25%-75% quantiles (Q25-Q75): 2.0-5.5] in the electronic chart and 5.0 hazards (Q25-Q75: 3.0-6.75) in the paper chart (equivalence testing, p = 0.005). For the gastrointestinal bleeding case, the students identified a median of 5.0 hazards (Q25-Q75: 4.0-6.0) in the electronic chart and 5.0 hazards (Q25-Q75: 3.0-6.0) in the paper chart (equivalence testing, p < 0.001). We detected no improvement between the first case [median 5.0 (Q25-Q75: 3.0-6.0)] and second case [median, 5.0 (Q25-Q75: 3.0-6.0); p < 0.001, test for equivalence]. Electronic charts do not seem to facilitate advanced medical students' recognition of patient hazards during chart review and may impair expertise formation.

Indexed as

Electronic Health RecordsHealth Records, PersonalPatient SafetyStudents, MedicalAdultDiabetes ComplicationsDiabetes MellitusEducation, MedicalFemaleGastrointestinal HemorrhageHumansMaleRecognition, PsychologyYoung Adult

Identifiers

PMID32214333
PMCPMC7098576
OpenAlexW3013014563

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.