Experience of introducing electronic health records station in an objective structured clinical examination to evaluate medical students' communication skills in Canada: a descriptive study.

Abstract

There is limited literature related to the assessment of electronic medical record (EMR)-related competencies. To address this gap, this study aims to explore the feasibility of EMR objective structured clinical examination (OSCE) station to evaluate the medical students' communication skills by psychometric study and standardized patients' (SPs) perspectives on EMR use in OSCE. An OSCE station that incorporated the use of an EMR was developed and pilot-tested in March 2022. Students' communication skills were assessed by SPs and physician examiners. Student's score in EMR station was compared with that of other 9 stations. Psychometric analysis, including item total correlation was done. SPs participated in a post-OSCE focus group to discuss their perception of EMRs' effect on communication. Ninety-nine 3rd year medical students participated in a 10-station OSCE that included the use of the EMR station. The EMR station had an acceptable item total correlation (0.217). Students who leveraged graphical displays in counseling received higher OSCE station scores from the SPs (P -value). Thematic analysis of the SP perception of students' EMR use from the focus group revealed the following domains of themes: technology, communication, case design, ownership of health information, and timing of EMR usage. This study demonstrated the feasibility of incorporating EMR in assessing learner communication skills in an OSCE. The EMR station had acceptable psychometric characteristics. Some medical students were able to efficiently use the EMRs as an aide in patient counseling. Teaching students how to be patient-centred even in the presence of technology may help with engagement.