POSTER

Design of a Bilingual Online Learning Environment about Electronic Medical Records

Adol Esquivel, MD, Sarah Edmonson, MD, Smitha Sagaram, MD, Pallavi Mokkarala, MS, Craig Johnson, Ph.D, Cynthia Phelps, Ph.D, University of Texas Health Science Center at Houston, School of Health Information Sciences, Houston, Texas, USA

ABSTRACT:

Introduction: Electronic medical records (EMR) are an increasingly important topic in medical care throughout the North American continent; a high percentage of practices plan to invest in an EMR in the near future. Yet, many physicians do not have access to good in-person education about electronic medical records. In addition to the English-speaking physicians in the United States and Canada, many Spanish-speaking doctors in Mexico and Central America are in need of a well-designed introduction to the components and capabilities of commercial EMR products. We attempt to resolve this dilemma by designing online education materials about electronic medical records. These materials, available in both English and Spanish, are designed based on adult education theory and are rigorously tested for usability and efficacy in both English and Spanish-speaking populations.

User analysis: Our initial audience includes two groups. The first includes faculty, residents, and students at Baylor College of Medicine in Houston, Texas. The second consists of faculty and students at the ITESM School of Medicine in Monterrey, Mexico. Evaluations of learning effectiveness in these very different groups will demonstrate the robust educational capability of the program. All potential users have completed formal education in a scientific discipline, have at least some clinical experience, and have a history of self-motivation. All have adequate experience with Internet usage and have access to the Internet in a work or home setting.

Program description: The learning environment design is driven by educational theory about what is most effective for this type of learner. Applicable theories include learning development theories, such as those developed by Piaget and by Perry; lifespan psychology principles; Knowles’ andragogy theory; experiential learning theory and learning style theory, as explored by Kolb among others, and Cross’s adult education theory. These various approaches offer the following consensus suggestions:

· Content should reflect the learner’s experiences and motivations

· Learning should be self-directed and self-paced

· Environment should be interactive

In order to accomplish these goals, the program is divided into five learning modules. A module on EMR components offers descriptions of functions commonly included in EMR systems. Another module reviews the differences between computer and paper records. The security module discusses protecting records from accidents or malicious intervention. One module explores the uses and limitations of EMR in research. Finally, a module on implementation discusses cost, workflow, and quality of care changes seen with EMR implementation.

Each module offers didactic material, as well as additional resources such as case histories, online information, a bibliography, and self-test questions. In addition, a hyperlinked glossary and links to vendor demonstrations are included. A consistent navigation scheme provides structure but allows control over the order and content of learning. Evaluation: The completed program was subjected to expert evaluation of content, interface, and usability characteristics. In addition, we applied heuristic usability analysis to the website, and it was reviewed by a set of prototypic users from each site. After these initial evaluations, pre- and post-test surveys were developed, containing items relating to user demographics, user satisfaction with the material, and content criterion items based on the learning objectives from each module. These tests were used to evaluate satisfaction and learning efficacy associated with the module for each cultural group. Conclusion: An online learning environment is a very appropriate forum for self-education about electronic medical records. Our program incorporates a variety of measures to ensure effective learning for our users, and is designed to be effective for a multicultural audience.

BENEFIT TO PARTICIPANTS ATTENDING SESSION:

While online continuing medical education has become relatively common, very few programs acknowledge the increasing globalization of medicinal education needs in their design. Our program is a rare example of an online learning environment, which has been evaluated rigorously by multiple empiric and theoretical standards. In addition, it is an even more unique example in that the evaluation process was carried out in parallel in two very different linguistic and cultural settings.

Adol Esquivel, MD

University of Texas Health Science Center at Houston,

School of Health Information Sciences,

7000 Fannin Sutie 600, Houston TX, 77030

Phone: 713-500-3926

Fax: 713-500-3929

mailto:Adol.Esquivel@uth.tmc.edu

CO-AUTHORS:

Sarah Edmonson, MD, Smitha Sagaram, MD, Pallavi Mokkarala, MS, Craig Johnson, Ph.D, Cynthia Phelps, Ph.D

University of Texas Health Science Center at Houston, School of Health Information Sciences, 7000 Fannin Sutie 600, Houston TX, 77030

Phone: 713-500-3926

Fax: 713-500-3929

mailto:Cynthia.L.Phelps@uth.tmc.edu