Abstract:

Background:
Health information technology (HIT) has revolutionized the world in its influence on health care. Medical students’ attitudes towards HIT tools (e.g., electronic medical records [EMR], computer physician order entry system [CPOE]) may influence their willingness learn, adopt and utilize these tools. User acceptance is considered as one of the critical factors for successful information technology (IT) adoption. However, scarce information is available on which factors influence medical students’ readiness for HIT engagement and utilization prior to residency placement. The purpose of this study was to investigate medical students’ knowledge, attitudes, and behaviors regarding HIT and to identify which factors are related to their readiness to utilize it in future clinical practice.

Methods:
A cross-sectional study was conducted collecting quantitative data via a questionnaire administered to all 979 students currently attending a large southeastern United States medical school. The survey was offered in pen-and-paper format and via SurveyGizmo, a commercial, web-based electronic data capture tool for research studies. Under the three major domains (knowledge, attitudes, and utilization), the following content areas were assessed:
1) personal characteristics,
2) HIT knowledge,
3) computer self-efficacy,
4) perceived ease of use and usefulness of HIT,
5) openness to change,
6) attitudes to toward mobile technology,
7) utilization of IT.

Results:
Nearly two-thirds (N=604) of the students completed the survey. Four hundred seventy seven (79%) were preclinical medical students (years 1 and 2) and 127 (21%) were clinical students (years 3 and 4). About half of the sample were women (n=258; 48%). Participants ages ranged from 20 to 47 years (mean=25.4 years). Only 9 clinical students (7.1%) reported having had much training in HIT systems (e.g., EHR/EMR; CPOE); only 20.5% (n=26) received instruction in the use of EHR/EMR in school. Multivariate regression modeling successfully explained 26% of the variance in predicting students’ readiness to utilize HIT tools in future clinical practice, F(8, 506) = 22.6, p < .001, R2= .263. Greater IT self-efficacy when using computer technology, higher scores on openness to changes (in academic/work settings), more favorable attitudes toward HIT utilization, younger age, being male, and prior experience with IT were associated with readiness to utilize HIT.

Conclusion:
Medical informatics should be integrated using specially designed classrooms where students are motivated, and not merely instructed, to learn how to use HIT technologies. Knowledge alone may not be sufficient in preparing students to embrace HIT. Increasing student self-efficacy regarding computer and information technology use, encouraging openness to change, and engaging students in hands-on HIT utilization practice in school may help escalate their readiness to use HIT technology in future clinical practice. Medical schools must not only teach core biomedical informatics competencies that address HIT but also must motivate students to be high-functioning users in the clinical setting. While future research in this area is warranted, findings from this study may help guide medical education curriculum enhancements to better prepare tomorrow’s physicians in HIT engagement and utilization.

Keywords:

Student readiness, health information technology (HIT), medical school curriculum, HIT utilization.