eDOC App: A Digital Solution to Mastering Electronic Medical Record Competency in Physiotherapy Education

<p dir="ltr">Background: The ability to read, interpret, and synthesize electronic medical records (EMRs) is a critical competency for Physiotherapy (PT) students. Traditionally, these skills are introduced during clinical placements. However, due to the complexity and large volume of information in real EMRs, acquiring EMR competencies in a clinical setting involves a steep learning curve, often leading to high stress and anxiety. Both students and clinical educators have appealed for structured exposure to digital health technologies before clinical placements to ease this transition. To address this gap, we developed a web-based applied learning solution to facilitate pre-clinical EMR training. </p><p dir="ltr">Method: A multidisciplinary team comprising PT faculty, Information and Communications Technology specialists, and educational development professionals collaboratively designed eDOC, an interactive web application that enables the use of real-life EMR data as the basis for case creation, ensuring authenticity and relevance to practice. Functionalities such as flagging critical information, an annotation notepad for summarizing key information, and structured prompts are tools to scaffold the learning. Students engage with virtual EMRs and submit an oral synopsis of patient histories within a designated time frame. A beta version of eDOC was piloted with 5 Accelerated PT students in 2023. Its effectiveness was evaluated through course feedback and serial surveys measuring students' perceived readiness for EMR competency at baseline, post-training, and early into clinical placement. Based on initial findings, new features were developed to enhance the application's stability and functionality. The improved version was implemented in 2024 for 157 students. To further evaluate its impact, the end clinical placement scores of students who trained with eDOC were compared with a historical cohort who did not have this training. </p><p dir="ltr">Result: The pilot cohort rated eDOC highly effective in achieving the learning outcome of collating and summarizing key EMR information (mean score 6.8/7). Students also found the tool extremely helpful for knowledge and skill acquisition (6.8/7). The perceived readiness to provide a comprehensive medical history improved from 2.6 (baseline) to 3.1 (post-training) and remained stable at 3.3 during early clinical attachment (scale: 1=not prepared, 5=very well prepared). The readiness was validated by clinical educators who rated students as 'adequate' (n=2) or 'proficient' (n=3) in selecting relevant clinical history and investigations. When comparing the 157 students who used eDOC with a historical cohort, no significant difference was found in end clinical attachment score (72.67 vs. 71.54, t(317)=-0.866, p=0.387) or competency in selecting relevant history and investigations (U=12769.500, p=0.924). </p><p dir="ltr">Conclusion: Rapid digitalization of healthcare underscores the necessity for training in this dynamic and ever-changing field. While clinical placement remains the most important means of building EMR competencies, the eDOC application provides pre-clinical students with valuable practice opportunities in building EMR competencies, enhancing their perceived readiness and confidence.</p>