Supporting resident inbox management with screen-casted videos

Abstract

Managing an electronic health record (EHR) inbox is a task required of most practicing physicians regardless of specialty. With the increased adoption of EHRs, the volume of material getting routed to clinician inboxes has increased, making this task ever more challenging. No clear standards exist for how to teach inbox management to trainees such as medical residents. Internal medicine residents report challenges with inbox management and cite it as a source of frustration. Not all faculty are facile with the EHR and prepared to teach this topic to learners.

To address this problem, our institution created a support infrastructure to guide residents in inbox management. In addition to pre-clinic conference sessions teaching inbox management to learners, we created a series of screen-casted videos to demonstrate to residents how to perform various inbox management tasks. For these videos, we used a training environment in our EHR with faculty voice-over guidance to explain how to perform various tasks while displaying task completion in real time on the screen. These videos covered various topics including managing results, patient calls and prescription refill requests, to name a few. We housed the videos on the password-protected website that contains reference material and resources for all residency rotations to protect proprietary EHR information. In subsequent years, we expanded video use with incorporation of the videos into pre-clinic conference teaching sessions.

In prior years, teaching on EHR navigation had been done by any faculty member supervising in resident clinic, regardless of their own degree of skill in navigating the EHR used primarily by residents. While this allowed for flexibility in the teaching schedule, the teaching may have been suboptimal if done by someone with less EHR experience. It also created the potential for inconsistencies in expectations since different faculty teachers may have presented material and expectations slightly differently. The creation of videos allowed us to use this material both for on-demand reference and for formal teaching sessions. During teaching sessions, faculty play the videos and facilitate a discussion with residents while further honing their own EHR skills such that they become better positioned to guide residents in EHR navigation during clinic sessions. Using the videos in our teaching has created greater uniformity of expectations which is essential for skills like EHR use and documentation. Despite the high quality of the videos and feedback on their utility, residents often forgot they existed and rarely accessed them on their own without prompting. This makes it essential to re-visit material in formal teaching or to disseminate reminders regarding the availability of useful reference material. Additionally, with frequent updates to the EHR, it is important to re-visit and update content on a regular basis to ensure material presented remains up to date.

None.

Ethical approval was not required based on the nature of this project.