Integrating Documentation Throughout the Curriculum: Strategies for Programmatic Quality Improvement

Context Athletic training programs must teach students how to document patient care, including using electronic records to manage patient records. However, athletic trainers and educators have described challenges and infrequent engagement in clinical documentation practices during didactic and clinical education. Objective Conduct a programmatic quality improvement (QI) initiative to improve the instruction of documentation practices throughout a professional athletic training program. Background Like published research findings, our program faculty experienced challenges with students’ understanding and application of clinical documentation. Therefore, I led our faculty through a QI activity to strategically improve how and when clinical documentation was taught and applied throughout our curriculum. Description I began by collecting baseline information about when and how documentation was taught in the program, including leading faculty through a strengths, weaknesses, opportunities, threats analysis; inventory of current assignments and activities; and discussion of student performance and feedback data. We identified strategies for teaching different types of documentation, engaging students more in electronic documentation, and translating documentation to clinical education experiences. We implemented these changes throughout 1 academic year and reassessed our performance. Overall, we were satisfied with the improvements made to our students’ documentation, and we plan to continue using the educational resources and strategies we implemented. Educational Advantage(s) We used several cost-free resources, including an online clinical documentation continuing education course and an academic electronic medical record, to improve our students’ engagement with documentation throughout the curriculum. Using the principles of continuous QI, we connected these programmatic changes to assessment outcomes to improve our students’ clinical documentation performance. Conclusions As athletic training programs strive to meet accreditation standards specific to documentation practices and continuous QI, faculty may consider using some of the strategies outlined in this educational technique paper to improve students’ engagement in documentation practices throughout the curriculum.