Evaluation of a computer tracking program for resident-patient encounters.

OBJECTIVE: To examine the effectiveness of a formal tracking system for residents' clinical experiences. DESIGN: We examined three shifts, selected at random, for each resident (without residents' knowledge) during emergency rotations. Information from patient charts was compared with residents' computerized records for rotation (location and preceptor) and patient (age, sex, diagnosis, and procedure) information. SETTING: The Northeastern Ontario Family Medicine Program, a program designed to provide remote, rural, and northern resident experience. PARTICIPANTS: First-, second-, and third-year residents on emergency rotations in the academic years 1992 to 1994. MAIN OUTCOME MEASURES: Compliance, reliability, and validity of tracking records. RESULTS: Residents recorded patient encounters 88% of the time. Compliance with rotation information was high (100% rotation, 94% preceptor). Agreement on patient age and sex was high. Procedure compliance was somewhat lower (83%). Intrarater reliability (91%) and inter-rater reliability (78%) are acceptably high, as is validity when compared with a gold standard entry (88%). CONCLUSIONS: Regular entry of reliable and valid data is facilitated by the computerized resident-patient encounter tracking program. This computer tool should prove useful for multilevel program evaluation in the future.

Computer-based patient encounter tracking. Development of a system for family medicine residents.

Tracking residents' experiences in clinical settings is difficult. We describe a computerized tracking program that can be used to catalogue and evaluate clinical experience. Using the program, learners can evaluate and validate their experiences, and educators can identify setting and preceptor strengths and weaknesses. The program is adaptable to other settings, inexpensive, and easy to use.

First-year family medicine residents' use of computers: knowledge, skills and attitudes.

OBJECTIVE: To identify the computer knowledge, skills and attitudes of first-year family medicine residents. DESIGN: Cross-sectional survey of family medicine residents during the academic year 1993-94; sampling began in July 1993 and ended in October 1993. SETTING: Canada. PARTICIPANTS: All 727 first-year family medicine residents, of whom 433 (60%) responded. OUTCOME MEASURES: Previous computer experience or training, current use, barriers to use, and comfort with and attitudes regarding computers. RESULTS: There was no difference in age or sex between the respondents and all first-year family medicine residents in Canada. French-speaking respondents from Quebec were underrepresented (p < 0.001). Only 56 respondents (13%) felt extremely or very comfortable with computer use. The most commonly cited barriers to obtaining computer training were lack of time (243 respondents [56%]) and the high cost of computers (214 [49%]) but not lack of interest (69 [16%]). Most residents wanted more computer training (367 [85%]) and felt that computer training should be a mandatory component of family medicine training programs (308 [71%]). CONCLUSIONS: Computer knowledge and skills and comfort with computer use appear low among first-year family medicine residents in Canada, and barriers to acquisition of computer knowledge are impressive. Computer training should become an integral part of family medicine training in Canada, and user-friendly applicable computer systems are needed.