Background and purpose

To describe a pilot study testing a metacognition and contemplative pedagogy intervention designed to improve student abilities to identify errors on orders entered into a computerized provider order entry (CPOE) system.

Educational activity and setting: Student teams worked up five patient cases and entered new orders into a CPOE system. All orders entered by teams were analyzed for errors and faculty members identified fifteen orders representing the top errors and selected these for the pre-exercise, in-class contemplation activity, and post-exercise. Course instructors instructed students to identify all errors on these orders. Students completed a pre/post-survey rating their ability to enter new orders. Two weeks later, students worked up a new patient case and entered orders into the CPOE. These orders were graded and scores were compared to the 2017 cohort to determine any differences in error rates.

Findings

Study participants included 205 students The average score of correctly identified errors increased from 22% on the pre-exercise to 62.8% on the post-exercise. On the survey of their skills, students rated their ability to “accurately enter medication orders into the [electronic health record] EHR” more highly after the intervention. The 2017 cohort made 73 errors on 170 orders compared to 45 errors on 165 orders by the 2018 cohort.

Summary

Based on improvements in student ability to identify order entry errors and overall positive student feedback, this strategy may be adopted by other educators looking to improve student identification of errors on orders entered into a CPOE system.

中文翻译：

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使用元认知和思考干预提高学生识别订单输入错误的能力

背景和目的

描述一项试点研究，测试元认知和思考式教学干预，旨在提高学生识别输入计算机化供应商订单输入 (CPOE) 系统订单错误的能力。

教育活动和环境：学生团队处理了五个患者病例并将新订单输入到 CPOE 系统中。对团队输入的所有订单进行了错误分析，教职员工确定了代表最高错误的 15 个订单，并为练习前、课堂思考活动和练习后选择了这些订单。课程讲师指导学生找出这些订单上的所有错误。学生完成了一项调查前/调查后评估他们输入新订单的能力。两周后，学生们处理了一个新的患者病例并将订单输入到 CPOE。对这些订单进行评分，并将分数与 2017 年的队列进行比较，以确定错误率的任何差异。

发现

研究参与者包括 205 名学生 正确识别错误的平均分数从练习前的 22% 增加到练习后的 62.8%。在他们的技能调查中，学生对干预后“准确地将药物订单输入[电子健康记录] EHR”的能力给予更高的评价。2017 年的队列在 170 个订单上犯了 73 个错误，而 2018 年的队列在 165 个订单上犯了 45 个错误。

概括

基于学生识别订单输入错误的能力和整体积极的学生反馈的改进，其他教育工作者可能会采用此策略，以提高学生对输入 CPOE 系统的订单的错误识别能力。