Training residents in medical informatics
This is a review of Jerant AF's 1999 article, Training residents in medical informatics. 
This article provides an overview of approaches to providing medical informatics training to Family Practice Residents. An eight step process is suggested to improve medical informatics training.  The importance of medical informatics training is evidenced by a recent study in 1999 stating that those who received medical informatics training had a far higher adoption rate of using electronic medical record systems (EMRs). The national average is 2-3% while in this study 24% adopted EMR's after medical informatics training.
- Conduct a needs assessment
- Review expert recommendations
- Enlist faculty and local institutional support
- Espouse a human-centered approach
- Integrate informatics training into the larger curriculum
- Provide easy access to computers
- Provide practical training
- Measure and report educational outcomes
The methods to collect information were from Medline articles from the dates of 1966-1999, solicited new articles from Fam Med and Med Ed as well as interviewing existing residents. A total of 154 relevant articles were reviewed with the majority coming from EMR and others from access to evidence-based medicine resources, clinical experience documentation and reporting, computer-assisted video skills evaluation, decision support software, e-mail, World Wide Web educational resources and personal digital assistants.
There are many success stories using medical informatics tools. Residents using cart resources with a CD-ROM of Medline and Cochrane Library residents were 81% likely to seek evidence that affected diagnostic and/or treatment conditions and 90% of outcome affected searches were deemed to be successful. QMR (Quick Medical Reference) was used with an improvement in overall diagnostic scores. Distance Learning was also a useful tool - a review of 13 distance learning rural family practice residents 75% reported using video technology.
With successes there are barriers to further success. Formalized medical informatics training is common in medical schools but not in residency training. Ownership of computers and having a solid base of computer skills is much lower in residency students than first year medical students. In a 1995 survey of 247 family practice residents there is apparent readiness to embrace the use of EMRs. Most reported being “somewhat likely” or “very likely” to implement an EMR at their program in the following 3 years.
From this study it is apparent at the time of writing there is a gap in medical informatics knowledge and computer skills for residents as compared to medical students. In addition, there is resident willingness to further their computer skills and informatics knowledge. As residents increase this knowledge they will be more likely to adopt successful informatics tools to improve clinical practice.
- Jerant AF. Training residents in medical informatics. Fam Med. 1999 Jul-Aug;31(7):465-72. http://www.ncbi.nlm.nih.gov/pubmed/10425526