A mixed methods evaluation of a tool assessing Adult Learning Theory content in EHR training
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Sophisticated Electronic Health Record (EHR) applications, such as Computerized Physician Order Entry, (CPOE) are being rapidly implemented in a variety of clinical settings. While there is a lack of published research to guide the design, execution and evaluation of strategies for the teaching and learning of EHRs, researchers have identified training gaps as a potential cause of EHR implementation problems. The significance of this research stems from the unprecedented numbers of physicians, nurses, and other clinicians engaged in training for Electronics Health Records. This explosion in EHR training is due in large part to Medicare and Medicaid EHR Incentive Programs established through the Recovery Act/HITECH Act of 2009. With incentive payments tied to the "Meaningful Use" of EHRs rather than simply to their implementation, a focus on effective and efficient training has come to the forefront. Adult Learning Theory (ALT) is well established in the literature as an important framework in the education and training of adult populations. Research into the design and delivery of EHR training programs in the context of clinicians as adult learners is needed. The study will use a scoring tool previously developed and validated to assess documents for evidence of ALT principles in the design and delivery of Continuing Medical Education (CME) programs, Reporting of Adult Learning Principles (RALP). The study design is a formative evaluation using mixed methods to assess the feasibility of the RALP tool to assess the presence of ALT principles in hospitals' CPOE training programs. The addition of a tool that evaluates EHR Training Programs based on their content, rather than perception surveys, will expand future researchers' abilities to evaluate EHR training programs, and explore the relationship between the inclusion of ALT principles and training outcomes. The study finds the RALP to a reliable instrument for the evaluation of ALT principles in EHR training program content. The study identifies future research opportunities for the use and adaptation of the RALP instrument. Finally, the study also identifies potential for the research to be useful in related fields of study, such as instructional design and workforce development.
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