Electronic health records in outpatient clinics: Perspectives of third year medical students

Abstract Background United States academic medical centers are increasingly incorporating electronic health records (EHR) into teaching settings. We report third year medical students' attitudes towards clinical learning using the electronic health record in ambulatory primary care clinics. Methods In academic year 2005–06, 60 third year students were invited to complete a questionnaire after finishing the required Ambulatory Medicine/Family Medicine clerkship. The authors elicited themes for the questionnaire by asking a focus group of third year students how using the EHR had impacted their learning. Five themes emerged: organization of information, access to online resources, prompts from the EHR, personal performance (charting and presenting), and communication with patients and preceptors. The authors added a sixth theme: impact on student and patient follow-up. The authors created a 21-item questionnaire, based on these themes that used a 5-point Likert scale from "Strongly Agree" to "Strongly Disagree". The authors emailed an electronic survey link to each consenting student immediately following their clerkship experience in Ambulatory Medicine/Family Medicine. Results 33 of 53 consenting students (62%) returned completed questionnaires. Most students liked the EHR's ability to organize information, with 70% of students responding that essential information was easier to find electronically. Only 36% and 33% of students reported accessing online patient information or clinical guidelines more often when using the EHR than when using paper charts. Most students (72%) reported asking more history questions due to EHR prompts, and 39% ordered more clinical preventive services. Most students (69%) reported that the EHR improved their documentation. 39% of students responded that they received more feedback on their EHR notes compared to paper chart notes. Only 64% of students were satisfied with the doctor-patient communication with the EHR, and 48% stated they spent less time looking at the patient. Conclusion Third year medical students reported generally positive attitudes towards using the EHR in the ambulatory setting. They reported receiving more feedback on their electronic charts than on paper charts. However, students reported significant concerns about the potential impact of the EHR on their ability to conduct the doctor-patient encounter.Peer Reviewe

Anthropometry and body composition in ethnic Japanese and Caucasian adolescent girls: Considerations on ethnicity and menarche

Objective: This study aimed to compare the various anthropometric and body composition parameters based on the ethnicity and the absence or presence of menarche.Design: A cross-sectional study with incomplete sampling, using the subject as the evaluation unit.Subjects: the final sample of 550 subjects was composed of 122 Japanese and 179 Caucasian premenarcheal adolescents, and 72 Japanese and 177 Caucasian postmenarcheal adolescents.Methods: the variables of body composition were measured through the following methods: bioelectrical impedance analysis, near-infrared interactance (NIR), Slaughter cutaneous skinfold equations and body mass index. Weight, height and sitting height were also evaluated.Results: the Japanese pre- and postmenarcheal girls presented lower weight and height values when compared with the Caucasian girls. in general, the Japanese premenarcheal girls presented less fat and fat-free mass than the premenarcheal Caucasian girls. This fact was demonstrated through NIR results. Conversely, the Japanese postmenarcheal adolescents accumulated more fat than their Caucasian counterparts. However, significant differences were solely encountered in the values of cutaneous skinfold percent body fat. With regard to menarche, it was verified that, regardless of ethnicity, all the anthropometric and body composition variables reached higher values among postmenarcheal adolescents when compared with premenarcheal adolescents.Conclusion: Different results of weight and height between the ethnic groups may bring back the discussion concerning separate growth curves for different ethnic groups. the results of the body composition analysis indicated high adiposity levels among postmenarcheal adolescents.Universidade Federal de São Paulo, Escola Paulista Med, Dept Postgrad Nutr, BR-04020060 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Prevent Med, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Postgrad Nutr, BR-04020060 São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Prevent Med, São Paulo, BrazilWeb of Scienc

Anthropometry and body composition in ethnic Japanese and Caucasian adolescent boys

Background: the effect of environmental conditions on development, including growth, maturation and the fulfillment of genetic potential, can be identified through the study of the variations found among different ethnic groups in the same population. the objectives of the present study were: (i) to compare the various anthropometric and body composition parameters based on ethnicity and maturation stage in 31 Japanese and 99 Caucasian prepubescent boys and 50 Japanese and 98 Caucasian post-pubescent boys; and (ii) to assess body mass index (BMI) and its relationship with other methods of body fat evaluation.Methods: the percentage of body fat was measured using bioelectrical impedance, near-infrared interactance and Slaughter cutaneous skinfold equations.Results: Weight and height were statistically lower for the Japanese than the Caucasian subjects. There were no differences in body fat between the ethnic groups, but the Japanese subjects had statistically lower levels of fat-free mass. the gain in fat-free mass and the loss in body fat when attaining maturation were greater in the Caucasian subjects. the agreement of BMI with other methods was good in all of the groups but lower for the Japanese than for the Caucasian subjects.Conclusion: Height and weight differences between the ethnic groups indicated distinct genetic potential ranges. the body fat mass did not differ between the ethnic groups, but the degree of changes when attaining maturation in the Caucasian subjects was greater. If this difference were to be maintained between the groups then years later there would be a greater accumulation of fat in the Japanese subjects.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Postgrad Course Nutr, Paulista Sch Med, BR-04020060 São Paulo, BrazilUniversidade Federal de São Paulo, Postgrad Course Nutr, Paulista Sch Med, BR-04020060 São Paulo, BrazilWeb of Scienc