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Leveraging the Electronic Record: Nursing Student Development of Clinical Judgment.
Sarah M Calonder1, Kristina Thomas Dreifuerst2, Jacqueline Christianson1
1Marquette University College of Nursing, Milwaukee, Wisconsin.
The Journal of Nursing Education
|June 5, 2026
Summary
The electronic health record (EHR) aids nursing students' clinical judgment, particularly in medication administration. Integration into nursing curricula is recommended, though students engaged less with the reflection aspect of clinical judgment using the EHR.
Area of Science:
- Nursing Education
- Health Informatics
- Clinical Judgment Development
Background:
- Nursing organizations emphasize entry-level competencies, including clinical judgment and electronic health record (EHR) use.
- Understanding the EHR's role in nursing student clinical judgment is crucial for effective transition to practice.
Purpose of the Study:
- To explore how prelicensure nursing students utilize the electronic health record (EHR) to develop clinical judgment.
- To identify specific EHR functionalities that support or hinder clinical judgment in nursing education.
Main Methods:
- Qualitative descriptive study involving semistructured interviews with 18 prelicensure nursing students.
- Content analysis of interview data aligned with Tanner's clinical judgment model and the Lasater clinical judgment rubric.
Main Results:
- Students used the EHR to support clinical judgments, especially for safe medication administration.
- The EHR informed multiple domains of clinical judgment, with the reflection domain being least utilized.
- Barriers to effective student EHR use were identified.
Conclusions:
- The electronic health record (EHR) is a significant tool for developing nursing clinical judgment.
- Thorough integration of the EHR into prelicensure nursing curricula is recommended to enhance student learning and practice readiness.
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