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Medical student electronic health record (EHR) use increased from 2012-2016, but access grew faster than data entry. Variations exist across schools and clerkships, potentially impacting residency preparedness.

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Area of Science:

  • Medical Education
  • Health Informatics
  • Digital Health

Background:

  • Medical school graduates are increasingly expected to be proficient in electronic health record (EHR) use.
  • Little is known about the evolution of student EHR experiences over time and across institutions.

Purpose of the Study:

  • To examine shifts in U.S. medical student interactions with EHRs during clinical education (2012-2016).
  • To investigate how these interactions varied by clerkship and across medical schools.

Main Methods:

  • An online survey on EHR use was administered to 17,202 medical students post-USMLE Step 2 CK.
  • Multilevel modeling analyzed trends in EHR access and data entry for 7 core inpatient clerkships across 140 U.S. medical schools.

Main Results:

  • Likelihood of student EHR experiences showed upward trends, with access increasing more than data entry.
  • Trends varied by clerkship, with some disciplines showing faster growth.
  • School-specific trajectories for EHR access and data entry differed.
  • Greater variation in student data entry compared to access persisted across schools.

Conclusions:

  • Growing medical student EHR interaction indicates a commitment to training on safe and effective use.
  • Inconsistent educational opportunities may leave some students less prepared for EHR documentation and information transmission in residency.
  • Differential preparedness for EHR engagement upon residency entry is a concern.