Developing clinical judgment through the implementation of information and communication technology, such as the electronic health record (EHR)

Abstract

<p>Graduate nurses are expected to enter a technology-rich workforce with an understanding of the electronic health record (EHR) and how it is used to guide patient care. Limited access to EHRs in clinical settings may result in students entering professional practice with limited ability to understand the full potential of the EHR. Over a seven-week term, students enrolled in the Patient-Centered Care I course, during the 2018 Spring I term, participated in high-fidelity simulation and seminar activities that included an educational electronic healthcare record (EEHR). These activities were integrated into the course to guide students when making clinical decisions regarding patient-centered care. Of the 93 students, 14 participated in the pre-course self-assessment survey, and 10 participated in the post-course self-assessment survey. Only those students who took both the pre and post-course self-assessment were evaluated (11% response rate). This survey was not mandatory, however, the EEHR activities in the course were. Students used Lasater&rsquo;s Clinical Judgment Rubric to rate themselves in the dimensions of noticing, interpreting, responding, and reflecting. Overall, mean scores increased in three of the four dimensions of clinical judgment (noticing, interpreting, and reflecting). There was a significant difference under the criteria <em>focused observation</em>, for the dimension of noticing. There was marginal significance under the criteria <em>making sense of data</em>, for the dimension of <em>interpreting</em>, as well as marginal significance under the criteria <em>commitment to </em><em>improvement</em> under the dimension of <em>reflection</em>.</p>