The Effectiveness of Scenario-Based Training of Clinicians in the Use of Electronic Health Records – A Systematic Literature Review

Abstract

The digitalisation of healthcare represents another change challenge for clinicians, and the most prominent of these is the Electronic Health Record (EHR).  Adopting the EHR, including the training of clinicians of all disciplines, often does not occur effectively, which increases the risk of adverse events and the reduction in the quality and safety of clinical care.   The competent use of the EHR requires clinician user training.  One form of training is scenario-based. The questions asked of the literature in this SLR are what evidence exists as to the effectiveness of using scenarios to train clinicians in using the EHR, and is there a research gap in this evidence to inform future research?

To undertake this systematic review of the literature, the researchers implemented the PRISMA Method. Only highly ranked, health-related academic databases accessed through an electronic library catalogue were used to search for relevant peer-reviewed/refereed articles.  The decision to apply the PRISMA method was based on the PRISMA statement, which safeguards comprehensive reporting and transparency to ensure inferred recommendations and interventions are based on the best available evidence.  

6,898 records were returned from Boolean searches for articles published between November 2018 to November 2021.  Five articles were included for greater analysis following exclusions by title review, abstract review, and quality assessment.  Quality assessment of articles reporting empirical studies relating to the effectiveness of using scenarios in this type of training was performed using the standard quality assessment scoresheet by Kmet [48].

Three themes emerged from the literature.  The centrality of workflow, Clinician engagement are key, and scenario-based training is one of many training strategies implemented. 

The authors found that further rigorous research studies are required to enhance the evidence body for the continued usage of scenario-based training of clinicians to effectively use the EHR, particularly as the digital landscape within health continues to evolve.  Moreover, the authors posit that further research on scenario-based EHR training of clinicians should include:

1. Scenario-based training is just one part of a broader and blended EHR training suite.


2. Ensuring future studies encompass a diversity of all fields of clinical roles within the research and,


3. Include standardised terminology naming for clinicians' scenario-based EHR training within the studies.