Technology and clinician-learner interaction: how clinicians expect introduction of a new electronic health record to...

Electronic health records (EHRs) are increasingly common platforms used in medical settings to capture and store patient information, but their implementation can have unintended consequences. One particular risk is damaging clinician-learner-interactions, but very little has been published about how EHR implementation affects educational practice. Given the importance of stakeholder engagement in change management, this research sought to explore how EHR implementation is anticipated to affect clinician-learner interactions, educational priorities and outcomes.

Semi-structured interviews were conducted with a group of practicing oncologists who work in outpatient clinics while also providing education to medical student and resident trainees. Data regarding perceived impact on the teaching dynamic between clinicians and learners were collected prior to implementation of an EHR and analyzed thematically.

Physician educators expected EHR implementation to negatively influence their engagement in teaching and the learning they themselves normally gain through teaching interactions. Additionally, EHR implementation was expected to influence learners by changing what is taught and the students' role in clinical care and the educational dynamic. Potential benefits included harnessing learners' technological aptitude, modeling adaptive behaviour, and creating new ways for students to be involved in patient care.

Anticipating the concerns clinicians have about EHR implementation offers both potential to manage change to minimize disruptions caused by implementation and a foundation from which to assess actual educational impacts.