Abstract:

Introduction:
One of the most widely used health information technology tools is electronic medical records (EMR), yet the issue of whether to grant students access to EMR is currently in question. Attitudes towards electronic medical records (EMR) may influence medical students’ willingness to learn about these and other emerging technologies and successfully use them during graduate training. However, scarce information is available regarding student’s attitudes that may facilitate or hinder their future proficiency in documenting patient care. This study was to assess what attitudinal and psychosocial factors predicted medical students’ perceptions of usefulness and ease of use of EMR.

Methods:
Data were collected electronically or via hard copy from 804 medical students aged 18 years or older enrolled in two large medical schools in the United States (Florida and Texas) before or after a scheduled didactic lecture session, or via a link to the online survey delivered via email. Data were collected using REDCap, a secure electronic data capture tool and then transferred to the Statistical Package for the Social Sciences (SPSS®) software v. 25 for data cleaning and further analysis. The anonymous questionnaire contained a combination of validated measures regarding their attitudes toward their abilities to learn and interact with HIT. Under two major domains (attitudes and utilization), the following content areas were assessed: 1) perceived usefulness and of ease of use (PU-PEOU) of EMR, 2) attitudes toward mobile technology, 3) computer self-efficacy, and 4) flexibility. Data were analyzed using SPSS statistical software.

Results:
It was hypothesized that computer self-efficacy, flexibility, and attitudes toward mobile technology use in clinical practice will make significant contributions to PU-PEOU in medical students. Multivariate linear regression modeling successfully explained the 22% of variance in predicting students’ PU-PEOU of EMR (F(3,772)=20.638, p<.000, R2=0.222). Students with greater self-efficacy, more flexibility, and higher acceptance of mobile technology were more likely to perceive EMR as useful and easy to use.

Discussion:
The importance of EMR use in clinical practice is well-acknowledged in medicine, but perhaps no so much a part of the undergraduate medical education experience. This research addresses a gap in the medical education literature explicitly addressing students’ perceptions EMR use prior to graduate training. Findings from this study suggest a more innovate, tailored approach to medical education that include activities to establish confidence and demystify the technology. Findings from this study may help medical educators understand the underpinnings of students’ perceptions about both learning and using EMR to mitigate any ambiguity or misconceptions and better prepare them for clinical training. Policies surrounding student use of EMR should be revaluated to ensure future physicians are provided adequate training in patient care documentation.

Keywords:

Electronic medical records (EMR), health information technology (HIT), computer self-efficacy, mobile technology, flexibility.