Understanding the educational value of first-year medical students’ patient encounter data

Figures & data

Table

Practice points

Students see value in documenting patient encounters, but suggest that the purpose and expectations should be clearly conveyed and reinforced. Patient encounter tracking systems should be designed to maximize access and convenience for student-users. Benchmarks or guidelines may increase the educational utility of requirements for documentation for students. Students suggest that regular check-ins with a faculty member, a small group, and/or peers can generate a sense of accountability and ownership that encourages students to provide accurate entries. Collecting regular feedback from students and acting on this feedback is important for continuous system improvement, including ensuring accuracy of entries and educational value for students.

Figure 1. Screen shot from EncounterIt interface.

Table 1.  Distribution of “Notes to Self” content.

Category and description of content	Entries No. (%)
Clinical	655 (90%)
Clinical information pertaining to patient's chief complaint, symptoms, past medical history, meds, notable features of physical exam, assessment/diagnosis, treatment; descriptions of clinical skills or procedures performed or observed including patient education and counseling; biology of disease and connection to basic/clinical science
Psychosocial
Characterization of patient's living or family situation; perceptions of the patient's attitudes, concerns, feelings, psychological state	326 (45%)
Learning issues	250 (34%)
Identification of things learned during an encounter or session; identification of things to work on or to focus on learning; reflections related to learning; specific feedback points from preceptor; performance reminders
Professional / ethical	123 (17%)
Interpersonal skills and interactions with patients and other providers such as a difficult or awkward interview, challenging communication, importance of building trust / establishing rapport; positive role modeling; questions or concerns about decisions or observed behaviors
Personal / reflective	54 (7%)
Reference to student's personal situation or circumstances, insights to own emotions; reflections on personal / professional development

Note: 729 total entries.

Table 2.  Distribution of first-year medical student entries in EncounterIt.

Student user group	No. of patient encounters entered	No. of students No. (%)
Non-users	0	15 (10%)
Low users	1–3	37 (25%)
Low–moderate users	4–10	51 (34%)
Moderate users	11–15	24 (16%)
High users	16 or more	21 (14%)

Note: 148 students.