"5 Why Process"
for Problem Identification
What specific problem have you observed?
Students do not perform well charting medical history on electronic medical records systems the first round of clinical practicum rotation.
Why does / doesn't this happen?
Students do not read the Medical History Taking textbook.
Students do not adapt well with change from paper to electronic.
Why does / doesn't this happen?
They don't retain the eight elements of history of present illness.
They are only exposed to paper charting.
Why does / doesn't this happen?
They need more exposure to accurate and efficient medical history charting using an electronic system.
Why does / doesn't this happen?
I have not taught the students the standard of care on the use an electronic medical record.
Stop the "5 Why Process" when you believe you have identified the root cause of the original problem. Craig A. Mertler, PHD
Action Research
Design Development
1. The topic I'm thinking of doing action research on is......
- Will adding electronic medical record form increase engagement between the student and their patients in the first clinical practicum rotation.
2. The purpose of my study is to ......
- Enable the student to perform an accurate and efficient exam without losing sight of the patients' needs by staring at a computer screen.
3. My fundamental research question is ......
- By introducing both electronic medical form and paper charting will increase student engagement with the patient during the history taking process.
4. The most appropriate type of data for me to collect is .....
- To use a mixed-method of qualitative and quantitative.
Why?
- A mixed-method approach will get the viewpoints of both clinic and student on improvements for performing an accurate and efficient medical history and exam.
5. The specific form of data I will collect is.....
Quantitative method:
Student Likert-scale survey on perception of adding electronic charting method - Summer 2017
Written and Demonstration exams - Fall 2017
End of Course survey - Fall 2017
Weekly evaluations and Exit report from clinic practicum rotation - Spring 2018
Qualitative method:
Students journaling on Blackboard - Fall 2017/Summer 2018
Observations by Clinical coordinator and Clinic preceptor - Spring 2018/Summer 2018
6. Based on the preceding responses, my research design can best be described as....
- Increase student retention in taking a medical history and performing exam.
- Increase student charting skills of entering data on an electronic medical records system.
- Increase student's ability to adapt to changes in charting medical history and exam.
- Increase student's proficiency in delivering quality standard of care.
Remember.... All aspects of your study and its design must be PARALLEL!!! Craig A. Mertler, PHD
Planning for Data Collection
1. My action research topic is electronic medical records training enhances student engagement with patients in the clinic.
2. My research questions are will adding the training increase student-patient engagement and will it increase the student's ability to adapt to different medical charting methods.
3. Important demographic variables include differing EMR systems and standards of care among clinic preceptors.
4. The instrumentation needed to answer my research questions can best be described as demonstration of history taking skills, completed weekly evaluations, exit reports by clinical preceptor, observation by clinical coordinator and end of course student survey.
5. The following must be considered in my data collection process in order to answer my question varying perceptions on student/patient relationships.
6. Other potential data collections concerns I have include uncompleted student survey with an incentive and incomplete journaling by students for a grade.
2015 by Craig A. Mertler, PHD
Planning for Data Analysis
1. My research questions are the following.
- Will adding an electronic medical records form increase student/patient engagement?
- Will adding an electronic medical records form increase student's ability to adapt to differing systems?
2. I will answer my questions with both types of analysis; qualitative and quantitative.
3. I will analyze my date using computer software.
4. I will present my results in a narrative form with statistical analysis techniques using use Microsoft Excel and Blackboard programs.
2015 by Craig A. Mertler, PHD
Conclusion
Dr. Mertler puts excellent tools in place for teachers/instructors/learning facilitators to expand professional development for applications in the classroom. Starting with the Why process which identifies the need for change, then designing the action research development, collecting data and concluding with planning for data analysis and reflection. These useful tools have increased my knowledge and understanding of educational action research steps. In the past, I have only been involved with research collection of data and not the footsteps used for collection, analysis and reflection.
The review of the literature in EMR training aided me in answering my research questions. Reading the pros and cons of some successful methods of training gives me new insight on strategies to put in place in the class and lab sessions. I look forward to placing the EMR training plan into action in order to analyze the data, and starting a new action research plan to improve student learning, critical thinking, adaptability, communication and teamwork skills.