Electronic-clinical evaluation exercise (e-CEX): A new patient-centered EHR use tool

•EHR use can detract from the patient-doctor relationship and communication.•EHR use can also promote shared decision making, education and understanding.•E-CEX is a reliable, valid tool to assess patient-centered EHR communication skills.•E-CEX can be used to provide feedback to improve EHR use wit...

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Bibliographic Details
Published in:Patient education and counseling 2018-03, Vol.101 (3), p.481-489
Main Authors: Alkureishi, Maria Alcocer, Lee, Wei Wei, Lyons, Maureen, Wroblewski, Kristen, Farnan, Jeanne M., Arora, Vineet M.
Format: Article
Language:English
Subjects:
Clinical Competence
Communication
Educational Measurement
EHR
Electronic Health Records
Electronic medical records
Evaluation
Female
Health Records, Personal
Humans
Nursing
Patient-Centered Care - methods
Patient-provider relationship
Professional-Patient Relations
Reproducibility of Results
Students, Medical - psychology
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Summary:•EHR use can detract from the patient-doctor relationship and communication.•EHR use can also promote shared decision making, education and understanding.•E-CEX is a reliable, valid tool to assess patient-centered EHR communication skills.•E-CEX can be used to provide feedback to improve EHR use with patients. Electronic Health Record (EHR) use can enhance or weaken patient-provider communication. Despite EHR adoption, no validated tool exists to assess EHR communication skills. We aimed to develop and validate such a tool. Electronic-Clinical Evaluation Exercise (e-CEX) is a 10-item-tool based on systematic literature review and pilot-testing. Second-year (MS2s) students participated in an EHR-use lecture and structured Clinical Examination (OSCE). Untrained third-year students (MS3s) participated in the same OSCE. OSCEs were scored with e-CEX compared to a standardized patient (SP) tool. Internal consistency, discriminant validity, and concurrent validity were analyzed. Three investigators used e-CEX to rate 70 videos (20 MS2, 50 MS3). Reliability testing indicated high internal consistency (Cronbach’s alpha=0.89). MS2s scored significantly higher than untrained MS3s on e-CEX [e-CEX 55(10.7) vs. 44.9 (12.7), P=0.003], providing evidence of discriminant validity. e-CEX and SP score correlation was high (Pearson correlation=0.74, P
ISSN:0738-3991
1873-5134
DOI:10.1016/j.pec.2017.10.005