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Refocusing medical education in the EMR era

Refocusing medical education in the EMR era. Pageler, N. M., Friedman, C. P. & Longhurst, C. A. JAMA 310, 2249–2250 (2013).


How integration of EMR into medical education and the specific educational goals for its use have not been well-defined. The effect of the EMR on each Accreditation Council for Graduate Medical Education’s (ACGME) core competency and the role it may play in supporting the achievement of educational milestones is examined in this paper.


Stakeholders expect physicians to use health information technology to optimize individual and population health. This key recommendations to achieve this task are outlined in the figure (PDF, listed below).

  1. Competency in the use of EMR should be integrated into each aspect of medical practice as a tool for helping trainees achieve the 6 core competencies.
  2. Technology should play a supportive role – in each of the core competencies, and in true patient-centered care with the EMR positioned as a tool to achieve competency.
  3. Specific clinical decision support tools can be developed to address knowledge gaps, and alerts can be used to help identify such gaps. Institutions can also make available simulation-based training in EMR, allow medical students access to the EMR during clinical rotation, and can provide residents access to data analytic tools to identify their own patient management patterns and potential areas for practice-based improvement. Institutions can automate reports of each residents patient encounters to track achievements of milestones and can enable supervised e-mail and patient portal functionality for trainees.


Medical educators must create and support an EMR-enhanced curriculum tailored to the evolving practice of medicine to support EMR assimilation into medical education and the practice of medicine. Medical education tools that should be available within a high-yield EMR are summarized in a table within the paper.


This paper is concise, and offers key recommendations for institutions to adapt to the new reality of physician practice in a technology-rich environment. The framework of the ACGME competencies is leveraged to make suggestions for EMR tools to support these competencies. Institutions are offered guidance on what a trainee should know to effectively practice in their future environment, and strategies to help them attain skill in providing safe, patient-centered care within the context of EMR use. This article gets 5/5 checks.