Evaluating the Impact of Computerized Provider Order Entry on Medical Students Training at Bedside: A Randomized Controlled Trial
Computerized provider order entry (CPOE) systems have become more widespread in University hospitals where medical students first encounter them in their clinical rotations. However, there are very few studies to show how the CPOE systems are affecting the training of the medical students. The paper is an attempt to find out how much the CPOE systems are affecting the training.
The study was conducted in the Georges Pompidou European Hospital. Chief residents from Cardiology, Immunology and Internal Medicine participated in the study. Medical students in their last undergraduate year also participated in the study. The main outcome to look for was an increase of knowledge by the students. The residents and students were given a 57 items short open answers questionnaire to fill. The students also filled out a 27 items satisfaction questionnaire at the end of rotations. Statistics using ANOVA, intra-class correlations coefficients, and other tools were used for analysis of the results of the questionnaire and other data to assist in comparison of data. A control group and a test group were used.
The control group had test results that went from 69.87 to 80.98. The test group had test results that went from 64.60 to 78.11. Using what was known as bivariate analysis, the increase in test results were not statistically significant.
Students from all the groups showed an increase in knowledge but there wasn’t a noticeable difference between the groups. The small increase in knowledge has a multitude of explanations. Along with a discussion of the knowledge is statements about all of the factors that may have affected the knowledge outcome, ranging from how the chief residents affected the students to how the CPOEs themselves affected the students.
This paper is really interesting and talks about a topic that has been relatively untouched. The paper uses statistic measures to help understand CPOEs in medical training; the paper also acts as a nice gateway to seeing the results of CPOEs in medical training.
Interestingly, there is also a review article that investigated how effective CDSSs could help improve healthcare quality through a systemic literature review. The results are strikingly similar to this study, which CDSSs almost had no effects on achieving these desired clinical outcomes such as improved care quality and patient safety with effectiveness and efficiency .
- Wack, M., Puymirat, E., Ranque, B., Georgin-Lavialle, S., Pierre, I., Tanguy, A., … Avillach, P. (2015). Evaluating the Impact of Computerized Provider Order Entry on Medical Students Training at Bedside: A Randomized Controlled Trial. PLoS One, 10(9). http://doi.org/10.1371/journal.pone.0138094
- Bouaud, J. & Lamy, J.B. A 2014 medical informatics perspective on clinical decision support systems: do we hit the ceiling of effectiveness? Yearbook of Medical Informatics, 9 (1), 163-166.