Disease
Conditions
Keywords
electronic medical records, documentation templates, clinical encounter notes
Brief summary
The purpose of the study is to measure the effectiveness of a social marketing-based medical education intervention on student use of evidence-based templates for documenting outpatient asthma care within an electronic medical record.
Detailed description
The purpose of the study was to measure the effectiveness of a physician-educator led clinical documentation workshop, embedded with 7 persuasive social-marketing based messages, on medical student response using a targeted asthma template. Stated differently, whether a physician-educator could persuade medical students to use an evidence-based EMR asthma template to document an outpatient mild persistent asthma encounter with a patient.
Interventions
BEHAVIORALsocial marketing-based medical education intervention
social-marketing based medical education intervention designed to influence medical student use of evidence-based templates. Led by physician instructor.
Sponsors
Uniformed Services University of the Health Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Third year medical student completing family medicine clerkship Uniformed Services University
Exclusion criteria
* All students other than those listed above
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants Using Evidence-based Template to Document Asthma Care Within an Electronic Medical Record | immediately after invervention and 30+ days in follow-up | The primary outcome measure is a count of whether or not the research participant uses the electronic health record-based Asthma AIM form to document a simulated outpatient mild persistent asthma encounter at T1 (immediately following intervention) and T2 (upon completion of family medicine clerkship approximately 35 days later). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Note Completeness Score | immediately after intervention and 30+ days in follow-up | The Note Completeness Score is a total score (range 1-31)earned when a clinical encounter note is compared against a note completeness score assessment tool designed by our research team. The tool measures 11 documentation components of the outpatient note. Each of the 11 components are scaled either 0-1 or 0-4 based on perceived importance by our physician designers. |
Participant flow
Recruitment details
All 3rd year USU medical students rotating through Family Medicine clerkship were invited to participate. The clerkship groups scheduled every 6-8 weeks during the 2009/10 academic year. The study included both male and female participants; ratio based on assignment to rotation group which is predetermined by medical school administrative staff.
Participants by arm
| Arm | Count |
|---|---|
| Intervention Group Students exposed to educational workshop on clinical documentation that was embedded with 7 select social marketing-based persuasion messages; reenforced behavior-seeking and behavior-avoidance based on template use. | 75 |
| Control Group Students exposed to clinical documentation workshop void of any of the 7 social marketing-based persuasion messages included in the intervention. | 80 |
| Total | 155 |
Baseline characteristics
| Characteristic | Intervention Group | Control Group | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 75 Participants | 80 Participants | 155 Participants |
| Region of Enrollment United States | 75 participants | 80 participants | 155 participants |
| Sex: Female, Male Female | 26 Participants | 33 Participants | 59 Participants |
| Sex: Female, Male Male | 49 Participants | 47 Participants | 96 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 75 | 0 / 80 |
| serious Total, serious adverse events | 0 / 75 | 0 / 80 |
Outcome results
Primary
Number of Participants Using Evidence-based Template to Document Asthma Care Within an Electronic Medical Record
The primary outcome measure is a count of whether or not the research participant uses the electronic health record-based Asthma AIM form to document a simulated outpatient mild persistent asthma encounter at T1 (immediately following intervention) and T2 (upon completion of family medicine clerkship approximately 35 days later).
Time frame: immediately after invervention and 30+ days in follow-up
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Intervention Group | Number of Participants Using Evidence-based Template to Document Asthma Care Within an Electronic Medical Record | 41 participants |
| Control Group | Number of Participants Using Evidence-based Template to Document Asthma Care Within an Electronic Medical Record | 11 participants |
p-value: 0.0195% CI: [1.34, 11.79]log-binomial regression
Secondary
Clinical Note Completeness Score
The Note Completeness Score is a total score (range 1-31)earned when a clinical encounter note is compared against a note completeness score assessment tool designed by our research team. The tool measures 11 documentation components of the outpatient note. Each of the 11 components are scaled either 0-1 or 0-4 based on perceived importance by our physician designers.
Time frame: immediately after intervention and 30+ days in follow-up
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Clinical Note Completeness Score | 16.04 score | Standard Deviation 2.78 |
| Control Group | Clinical Note Completeness Score | 17.05 score | Standard Deviation 2.58 |
p-value: 0.0595% CI: [-2.48, -0.03]ANCOVA