Psychometric Evaluation of a Novel Electronic Health Record Competency Survey

Electronic health record competency is essential for safe nursing practice, yet academic curricula lack comprehensive, structured assessment tools aligned with competency-based frameworks. This quality improvement study developed and evaluated the psychometric properties of the Electronic Health Record Competency Survey based on the LEARN-EHR Model and PRACTICE Framework. The psychometric evaluation occurred in 2 steps. First, a panel of 10 experts evaluated the content validity of the 24 competency items across 8 domains. Second, following phased electronic health record training incorporating asynchronous learning, hands-on practice, objective assessment, remediation, and standardized patient simulation, 25 graduate nursing students completed the Electronic Health Record Competency Survey. Competency levels and internal consistency reliability were analyzed. The Electronic Health Record Competency Survey demonstrated excellent content validity (S-CVI/Ave=0.97) and internal consistency reliability (Cronbach's alpha=0.962), with domain subscales ranging from 0.811 to 0.978. All students achieved proficient-level competency (mean=6.13, SD=0.69 on a 7-point scale) across all PRACTICE domains. When integrated with objective performance measures within the LEARN-EHR model, the Electronic Health Record Competency Survey provides nursing programs with a comprehensive assessment strategy addressing AACN Essentials Domain 8 informatics competency requirements.