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Updated: May 1, 2026

An Assessment Method and Toolkit to Evaluate Keyboard Design on Smartphones
Published on: October 5, 2020
Keyboard data entry use among osteopathic medical students and residents
Julia M Helstrom1, Erik E Langenau, Jeanne M Sandella
1Physician Trainer for Clinical Skills Testing, NBOME, 101 W Elm St, Suite 150, Conshohocken, PA 19428-2004. jhelstrom@nbome.org.
Context:
Candidates taking the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) are currently evaluated on their ability to document clinical findings using a handwritten postencounter note. However, keyboard data entry is increasingly used for medical documentation.
Objective:
To determine the use and perception of keyboard data entry among osteopathic medical students and residents in educational and clinical settings.
Methods:
A Web-based survey regarding frequency of and preference for keyboard data entry was distributed to 9801 osteopathic medical students, 17,268 osteopathic residents, and 34 clinical deans of colleges of osteopathic medicine (COMs). In addition, 31 COMs' clinical skills center directors were contacted to participate in a telephone survey about the use of keyboard data entry in their centers.
Results:
A total of 1711 students, 1198 residents, 14 clinical deans, and 17 clinical skills center directors responded to the surveys. The majority of students (872 [51%]) reported using electronic keyboard data entry at their COM's clinical skills center for postencounter notes. Among respondents, 379 students (23%), 77 residents (9%), and 1 clinical dean reported that electronic keyboard data entry is never or rarely used during clinical rotations. Most trainees (1592 students [93%], 864 residents [94%]) reported that they were either comfortable or very comfortable with typing. Given the option of recording methods for SOAP (subjective, objective, assessment, plan) note findings on the COMLEX-USA Level 2-PE, 7 clinical deans were unsure of their students' preferences, while the remaining favored keyboard data entry (5) over handwriting (2). The majority of student and resident respondents would choose keyboard data entry (1009 [60%] and 511 [55%], respectively).
Conclusion:
Osteopathic medical students and residents are comfortable with typing; they are exposed to and would prefer using an electronic form of entry for medical documentation. These results support a conversion from written postencounter notes to keyboard data entry of notes on the COMLEX-USA Level 2-PE.
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