Educational instruction on a hospital information system for medical students during their surgical rotations

Abstract

Objective: To evaluate the benefit, for medical students on their surgical rotations, of real-time educational instruction during order entry on a hospital information system.

Design: Prospective controlled trial.

Intervention: Access to educational information during computerized order entry.

Subjects: Medical students in their final year at the University of Calgary.

Main outcomes: Attainment of the surgery rotation educational objectives, as measured by performance on a multiple-choice examination.

Methods: Before they began their surgical rotations, students at two hospitals took a multiple-choice examination to measure their knowledge of surgery. One hospital had an information system with computerized order entry; students at this hospital had access, while composing orders, to educational material on the system. The other hospital did not have an information system; students there wrote orders on a paper chart. At the end of the rotation, all students took another multiple-choice examination.

Results: Of 50 eligible students, 45 agreed to participate in the project, 21 in the treatment group and 24 in the control group. Pre-rotation scores were similar for the two groups (43 percent in the treatment group and 40 percent in the control group; SD, 10 percent). Post-rotation scores were identical for the two groups (65 percent in the treatment group and 65 percent in the control group; SD, 12 percent). A t-test analysis revealed no significant difference in performance on the examinations between the two groups.

Conclusion: This study did not demonstrate a learning advantage for medical students who have access to educational material on a hospital information system.

Figure 1.

Text from the ward problems screen. The problems are arranged by clinical presentation or laboratory results. Selection of a heading provides a hypertext link to the specific orders for that topic. In this example, the heading hyperkalemia, which is bolded for selection, provides a hypertext link to the next screen (Figure 2▶).

Figure 2.

Text from screen displaying the specific orders for the management of hyperkalemia. The student may either enter the orders or review the educational screen (Figure 3▶). Note: The generic form of Ventolin is albuterol; Humulin R is insulin; Kayexalate is sodium polystyrene sulfonate.

Figure 3.

Text from the educational screen for hyperkalemia. After reviewing the information, the student may return to the ordering screen (Figure 2▶) and enter the specific orders for the patient. Note: The generic form of Ventolin is albuterol; Kayexalate is sodium polystyrene sulfonate. ICF indicates intracellular fluid; ECF, extracellular fluid; ECG, electrocardiographic; p.o., by mouth; N.P.O., nothing by mouth; I.V., intravenous fluid.