Open Notes in Teaching Clinics: A Multisite Survey of Residents to Identify Anticipated Attitudes and Guidance for Programs

• DOI: 10.4300/jgme-d-17-00486.1
• Publication Date: 2018-05-07T19:38:59Z
• Authors: Bradley H. Crotty; Melissa Anselmo; Deserae Clarke; Joann G. Elmore; Linda M. Famiglio; Alan Fossa; Lydia Flier; Jamie Green; Jared W. Klein; Suzanne Leveille; Chen-Tan Lin; Corey Lyon; Roanne Mejilla; Matthew Moles; Rebecca A. Stametz; Michelle Thompson; Jan Walker; Sigall K. Bell
• Keywords: Worry

ABSTRACT Background Clinicians are increasingly sharing outpatient visit notes with patients through electronic portals. These open may bring about new educational opportunities as well concerns to physicians-in-training and residency programs. Objective We assessed anticipatory attitudes explored factors influencing residents' propensity toward note transparency. Methods Residents in primary care clinics at 4 teaching hospitals were surveyed prior implementation of notes. Main measures included resident the anticipated effect on patients, workload, education. Data stratified by site. Results A total 176 418 (42%) residents responded. Most indicated would improve patient engagement, trust, education but worried overwhelming being less candid, workload. More than half thought a good idea, 32% (56 176) they encourage read these wanted note-writing more feedback, 72% (126 175) feedback could communication skills. Attitudes effects safety, quality, medical varied Conclusions reported mixed feelings clinical patients. They advocate for notes, yet worry supervision, errors. Training site was correlated many attitudes, suggesting local culture drives support Strategies that address promote related be helpful.