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Evaluating the Impact of Computerized Provider Order Entry on Medical Students Training at Bedside: A Randomized Controlled Trial
Objective: To evaluate the impact of computerized provider order entry (CPOE) at the bedside on medical students training. Materials and Methods We conducted a randomized cross-controlled educational trial on medical students during two clerkship rotations in three departments, assessing the impact of the use of CPOE on their ability to place adequate monitoring and therapeutic orders using a written test before and after each rotation. Students’ satisfaction with their practice and the order placement system was surveyed. A multivariate mixed model was used to take individual students and chief resident (CR) effects into account. Factorial analysis was applied on the satisfaction questionnaire to identify dimensions, and scores were compared on these dimensions. Results: Thirty-six students show no better progress (beginning and final test means = 69.87 and 80.98 points out of 176 for the control group, 64.60 and 78.11 for the CPOE group, p = 0.556) during their rotation in either group, even after adjusting for each student and CR, but show a better satisfaction with patient care and greater involvement in the medical team in the CPOE group (p = 0.035*). Both groups have a favorable opinion regarding CPOE as an educational tool, especially because of the order reviewing by the supervisor. Conclusion: This is the first randomized controlled trial assessing the performance of CPOE in both the progress in prescriptions ability and satisfaction of the students. The absence of effect on the medical skills must be weighted by the small time scale and low sample size. However, students are more satisfied when using CPOE rather than usual training
Comparison of dimension scores between the case and control groups.
<p>Comparison of dimension scores between the case and control groups.</p
Cross-over schema and distribution of subjects.
<p>Cross-over schema and distribution of subjects.</p
Representative items in decreasing order of loading for each of the four dimensions.
<p>Representative items in decreasing order of loading for each of the four dimensions.</p
Drug order errors corrected by Chief Residents.
<p>Drug order errors corrected by Chief Residents.</p
Boxplots of the progress distribution on all questionnaire items for each (a) chief resident, (b) intervention group, (c) student.
<p>Boxplots of the progress distribution on all questionnaire items for each (a) chief resident, (b) intervention group, (c) student.</p
Scatterplots of the progress of the students on each item of the questionnaire between the beginning and the end of the rotation.
<p>Plots are shown with one row for each chief resident, left column for the Control group, and right column for the Case group. Item scores have been normalized. A smoothed estimator is fitted for each subplot.</p