A Model Curriculum for an Emergency Medicine Residency Rotation in Clinical Informatics.

Abstract

This curriculum is designed for emergency medicine residents at all levels of training. The curriculum covers basic foundations in clinical informatics for improving patient care and outcomes, utilizing data, and leading improvements in emergency medicine. The curriculum is designed for a four-week rotation. The American College of Graduate Medical Education (ACGME) mandated that all Emergency Medicine (EM) residents receive specific training in the use of information technology.1,2 To our knowledge, a clinical informatics curriculum for EM residents does not exist. We propose the following standardized and reproducible educational curriculum for EM residents. The aim of this curriculum is to teach informatics skills to emergency physicians to improve patient care and outcomes, utilize data, and develop projects to lead change.3 These goals will be achieved by providing a foundational informatics elective for EM residents that follows the delineation of practice for Clinical Informatics outlined by the American Medical Informatics Association (AMIA) and the American Board of Preventive Medicine (ABPM).4-6. The educational strategies used in this curriculum include asynchronous learning via books, papers, videos, and websites. Residents attend administrative sessions (meetings), develop a project proposal, and participate in small group discussions.The rotation emphasizes the basic concepts surrounding clinical informatics with an emphasis on improving care delivery and outcomes, information systems, data governance and analytics, as well as leadership and professionalism. The course focuses on the practical application of these concepts, including implementation, clinical decision support, workflow analysis, privacy and security, information technology across the patient care continuum, health information exchange, data analytics, and leading change through stakeholder engagement. An initial version of the curriculum was introduced to two separate institutions and was completed by three rotating resident physicians and one rotating resident pharmacist. A brief course evaluation as well as qualitative feedback was solicited from elective participants by the course director, via email following the completion of the course, regarding the effectiveness of the course content. Learner feedback was used to influence the development of this complete curriculum. The curriculum was graded by learners on a 5-point Likert scale (1=strongly disagree, 5 = strongly agree). The mean response to, "This course was a valuable use of my elective time," was 5 (sd=0). The mean response to, "I achieved the learning objectives," and "This rotation helped me understand Clinical Informatics," were both 4.75 (sd=0.5). Overall, participants reported that the content was effective for achieving the learning objectives. During initial implementation, we found that the preliminary asynchronous learning component worked less effectively than we anticipated due to a lower volume of content. In response to this, as well as resident feedback, we added significantly more educational content.In conclusion, this model curriculum provides a structured process for an informatics rotation for the emergency medicine resident that utilizes the core competencies established by the governing bodies of the clinical informatics specialty and ACGME. Clinical informatics key concepts, including definitions, fundamental terminology, history, policy and regulations, ethical considerations, clinical decision support, health information systems, data governance and analytics, process improvement, stakeholder engagement and change management.