As someone who aspires to be a health care provider, being a medical scribe seemed like a perfect entry job for me. There are many types of scribe training and I eagerly awaited my first day of ScribeAmerica job training. My paternal great grandparents were both physicians, and my aunt is a pediatrician who also specializes in diving medicine. Reading about their accomplishments and seeing my last name in news articles inspires me to make contributions to medical literature. My mother is an ER charge nurse and told me about ScribeAmerica at her work. I applied for a Scribe America medical scribe position and soon thereafter was accepted.
Medical Terminology Test
Before an applicant was considered eligible to start classroom medical scribe training, they had to pass a medical terminology and abbreviation entrance exam with an 80%. The exam had about 110 questions. To study for this test, I bought a pack of 200 index cards from the dollar store and pinned them to a bulletin board in my room. Learning the terms was not difficult for me because I took an online medical terminology class the summer prior.
Classroom Medical Scribe Training
In each of the seven classroom training days, we went over the various sections of the spiral bound training manual:
- Applications of medication terminology and abbreviations
- How patient flow works in a clinical setting
- Common physical exam findings
- Surgical procedures
- Family history conditions to ask about
Onsite Emergency Department ScribeAmerica Job Training
This information we learned helped prepare us for our one-on-one floor training shifts in the Emergency Department. On the first of three days, I was extremely nervous as I was not sure how employees treated each other in the hospital. I was also unsure of how other nurses and doctors would treat me because my mom was staff in the same hospital. To make things worse, when I looked in my backpack, I realized that I was missing most of the items the scribe manual listed for employees to bring to every shift.
Here are some common items a scribe should have for floor training:
- digital watch (it looks more professional to check the time on a watch than on a phone)
- headphones for listening to dictations
After greeting the trainer and physician I was working with for the day, I started taking notes on how to enter data about each patient. When we walked into the first patient’s room, I held my clipboard loosely and starting jotting down what the patient was saying. While I was writing, the physician started doing the physical exam and the trainer was already finished with typing the HPI and entering the pertinent symptoms in the ROS. I was amazed after witnessing my trainer’s speed and competence and hoped that one day I would reach that level. At the end of the first shift, the trainer said that I seemed very interested in the position, and wrote what to work on in my training manual.
On the rest of the training shifts, it was a gradual shift from the trainer doing mostly everything and me simply writing notes, to me entering the data and using the trainer as a reference guide to scribing. On the fourth day, my trainer left 4 hours early from the 12 hour shift and I did not have a single question that the physician could not answer. When I went home from that shift, I felt like a real scribe and I knew that this job–which was a stepping stone to being a health care provider–was what I wanted to do.
My First Day as an ER Scribe
On my first day alone I arrived exactly on time, at some ERs that is 15 minutes early, and printed out the physician’s physical exam normals. The first physical exam had 30 or more findings and none of them were normal, just another day in the ER. By the end of the 12 hour shift, the physician saw 22 patients (the average in a 12 hour shift is 20-25). Scribes can be a great asset to a physician because while the physician is assessing a patient, performing a procedure, or asking if a medication is working, a scribe can log that in the patient’s file. If a scribe does their job right, the timestamps on procedure notes (e.g. intubation, or chest tubes) can be done in real time to ensure correct logging times. In training, the definition of a scribe was “a medicolegal assistant to a physician.”
After a While I Became a Scribe America Trainer
After working for a while, I was asked to become a floor trainer for my locations and I happily accepted the position. I received training to be a floor trainer shortly after and had the opportunity to train a total of 7 scribes before leaving the position. Training was a little difficult at first because I am a very hands-off kind of teacher. I would rather the trainee fail during training and learn from it than fail later when I have no control over their actions. Some trainees were very confident and requested no help from the beginning. If they did this, then I would only comment when they were doing something wrong. I never heard anything from my supervisors that would suggest my teaching style received negative reviews. I always left good reviews for my trainees, because they all worked hard to get to floor training.
I take pride in the fact that all the scribes I trained are still on their way to becoming health care providers. One of my trainees later became chief scribe of the branch while I was still a trainer. To run classroom training, I had to sit in on a few classroom training sessions as an assistant. As a Scribe America classroom trainer, I had to grade my students’ tests and quizzes. Before the end of the each training day, I gave a performance review for each trainee. Oftentimes, I found myself lecturing students about what it was truly like to be a scribe. I would tell them to highlight words in the handbook that “may or may not be” on the next assessment. We also conversed as a class about how we think scribing was going to help us achieve our goals in the future. More specifically, I found myself lecturing on how to organize information on a sheet of paper, so notes don’t overlap and get confusing during the shift. Doing mock patient encounters with trainees is also a good way to engage the applicants, and to help prepare scribes better for floor training.
10 Medical Scribe Training Tips
- Before your first floor training day, try and remember the top 5 cardiac risk factors:
- Diabetes (DM)
- Family history of heart attack <55yo
- Always bring an extra pen, because you will probably lose yours and not all locations have a have a bag full of pens laying around (although you would be surprised)
- Bring homework or something else productive to do when the patient flow is slow (we call “slow” the “s-word” in the ER)
- If you work in the ER, never say “UGH IT IS SO SLOW TODAY”, because people will never fail to hear your call through the walls and come in.
- Try to have the HPI, ROS, PE (physical exam) done by time you are leaving the room with your healthcare provider to be the most efficient
- ALWAYS WRITE A TIME DOWN, EVEN WITH SECONDS IF SOMETHING IMPORTANT HAPPENED (e.g Time of death, Time that a medication is given, Time a procedure was started/finished, etc.)
- Leave your clipboard, digital watch, pen for work in your car so you never forget it
- Continue talking to the health care provider(s) that you have an inherent connection with, because having a letter of recommendation from one always looks good.
- Pay attention to how the healthcare provider’s version of the data entry software works, because:
- A different physician might have a question about it, and impressing physicians is always a good thing
- In the future, you will be that person, so if you pay enough attention, you will have a competitive edge against your classmates.
- And finally, be open to learning and new experiences. This job is supposed to help open your eyes to what the medical world has to offer. You just have to have the determination to see it.
Collectively, I believe that the transition from classroom training to floor training is the most difficult for trainees because it is difficult to convey how a day in the ER is going to go without actually being there. When I was in classroom training, we learned about patient encounters from educational company videos rather than pretending to be in a hospital and acting out different situations.
After moving 2 hours away from the hospital I used to work at, I had to take a break from scribing. I currently work online as a general transcriptionist who specializes in anything consisting of medical terminology. I have transcribed graduate-level lectures, podcasts, interviews, and medical records for clients, and have continued to learn about medicine.