A qualitative study to evaluate the effectiveness of simulation as a training method in implementation of electronic medical records

Background. Adoption of electronic medical records has been gradual in part due to physician concerns that its use in the exam room will interfere with the physician-patient relationship. Studies demonstrate their concern to be loss of eye contact with the patient and that entering information into the computer in the presence of the patient will interfere with communication.;Methods. Resident and attending physicians participated in a simulation with a standard patient which was videotaped. Their interactions and data entry into the electronic medical record were also recorded with a webcam and by the computer with the Morae(c) usability testing software to determine their proficiency with the electronic medical record application. The participating physicians viewed their video tapes in small groups and then did a second simulation where they could change anything about their communication method that they wanted to try. They then participated in focus groups where they evaluated the use of simulation as a training method for this purpose.;Results. The participants indicated that simulation is a helpful method for training physicians to integrate the electronic record into their communication with patients.;Conclusions. Communication training in medical education should include the use of the computer and simulation may be a valuable tool. It may also be helpful for experienced practicing physicians who are learning new technology.