29 October 2009
Introducing Medical Students to SystmOne
Fourth year medical undergraduates at the Leeds Institute of Health Sciences at the University of Leeds are being given the opportunity to learn about primary care clinical information systems (CIS) as part of their degree programme, thanks to funding from Bradford and Airedale Teaching Primary Care Trust.
The Yorkshire Centre for Health Informatics has worked with the Academic Unit of Primary Care to develop a training and education environment with a live electronic clinical information system (CIS), SystmOne, which is used in core learning and teaching for medical students.
Students get hands on experience of using the system and also learn about major issues important to the safe use of systems. They then use this knowledge in their GP placements to gain a better understanding of how systems are used in clinical practice.
The fourth year medical students have an initial two hour introduction session followed by an additional two hour session the following week, prior to them going out on their GP placements.
During the formal teaching session, the students log on to SystmOne, and enter a new patient's clinical details. They then watch a video of the patient's first consultation with the GP and record this full consultation in SystmOne. This enables them to explore and use clinical coding, prescribe medication, (both acute and repeat items) and use the clinical tools.
Students are actively encouraged to review each others' entries and explore the implications for medical record keeping, audit and informational continuity of care. This informs the current learning objectives by feeding in to many of the aspects of the chronic disease management module also studied on the course.
Learning about the CIS also informs other aspects of the students' learning including practical therapeutics, evidence-based practice and consultation and communication skills. Additionally, the programme coordinators hope that students will encourage engagement with their GP tutors in order to gain a greater understanding about what it is to be a GP in clinical practice today.
To date, four of the six formal sessions have been delivered, with four additional sessions, to 184 students. Dr Susan Clamp, Director of the Yorkshire Centre for Health Informatics, says, "Formal student feedback from these sessions is being evaluated but the engagement of the students and the lively discussions that have taken place in all the sessions give the impression that the students have responded positively to this learning."
This September, the team at Leeds University presented the project at the Association for Medical Education in Europe, in Malaga. Dr Clamp says, "We are the only medical school to incorporate the use of a computerised clinical system into our teaching. We're developing a new medical curriculum for 2010 and are extending the use of SystmOne throughout the new primary care teaching. In particular, we're extending the use of SystmOne in chronic disease management and we're increasing the amount we teach students about using and understanding electronic patient records. It's important for students to learn how to use a clinical system in a consultation, for prescribing and for communicating with other health workers."
Dr Clamp is also working with Connecting for Health on a project called 'Learning to manage health information'. As a board member on the Embedding Informatics in Clinical Education project, she has presented two conference workshops, providing a valuable contribution from the only medication school to be using a live clinical information system with medical undergraduates.
Dr Clamp continues, "I used to say that I couldn't teach students about General Practice without showing them the systems that are used - now I can do that. The clinical systems need to be embedded in clinical teaching, not separate to it. We're very lucky to have the resources to do this kind of work with our students. We have a supportive SHA and PCT as well as good links with CFH and TPP. "
So what do the students think of SystmOne? "They think it's a doddle - we don't even train them!" says Dr Clamp. "It's fascinating to see the differences in how the students use the system. Some Read code absolutely everything, whereas others write their consultations more like an essay. Then, of course, there are those that use a combination of both approaches. We don't tell them how to do it, it's up to them, and it has resulted in some good debate about the merits of coding versus free text."
Dr Clamp concludes, "The students are all bright and hugely IT literate so using the computer is not a problem. What we focus on are the bigger issues such as understanding the impact of sharing records, of Information Governance and data quality. It's interesting that they have no hang-ups about data sharing. Hopefully, we can turn doctors out who realise the potential for the electronic record in chronic disease and pathways. If we send them out understanding that, the belief is they'll do more and their patients will be the ones who benefit."
