One response to a recent challenge from the institute of medicine: a system to credential medical computer skills

Abstract

Our objective was to survey, evaluate, improve and credential the basic medical computer skills of all residents in our obstetrics and gynecology program. All of our residents were surveyed for their individual prior experience and attitude toward using computers. We then tested each resident individually using a clinical simulation, similar to the approach we have used for teaching and evaluating clinical skills. In this computer-based exercise, each resident is presented a clinical scenario outlining a virtual patient and then asked to accomplish, under direct observation, a predefined series of activities. We documented a wide range of prior training and experience among our residents. Although all reported a comfort level of “average” or “expert”, only 18% (2/11) were able to demonstrate competence in all areas tested; these residents were immediately credentialed without further instruction. The remaining 82% (9/11) demonstrated both some minor deficiencies that the examiner was able to rectify with minimal instruction, as well as significant difficulties using the slide preparation program that required formal classes to correct. Of the residents needing additional training in slide preparation, 67% (6/9) had had prior experience with that same software but nevertheless were unable to demonstrate correct use. After completing additional training, all of our residents were able to demonstrate acceptable competence in all areas of medical computer use that we tested, and they also were credentialed. Our conclusions were as follows: 1) Ob/Gyn residents initially may have varying levels of computer experience; their competence cannot be assumed simply based on prior education. 2) Basic medical computer skills of residents can be objectively evaluated using a testing system analogous to that applied to clinical skills. 3) Properly designed testing can identify specific areas of deficiency that can be efficiently addressed by individualized tutoring and/or group classes. 4) Such a system allows credentialing of residents for medical computer use.