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Association Between Centers for Medicare and Medicaid Services Student Note Policy Implementation and Physician Note
Kelli Mans1, Elizabeth Lyden2, Jason Burrows1
1Department of Pediatrics (K Mans, J Burrows, S Dolter, N Gollehon, A Guild, C McConnell, A Nabower, and N Goodrich), University of Nebraska Medical Center, Omaha, Nebr.
Academic Pediatrics
|June 13, 2026
Summary
Integrating medical student documentation into clinical workflows did not increase attending physician time. Residents spent less time editing student notes, indicating efficiency gains and supporting this educational practice.
Area of Science:
- Medical Education
- Health Informatics
- Clinical Documentation
Background:
- Medical student documentation is a key professional activity but opportunities are limited.
- A policy change enabled physician billing for student notes, prompting integration into daily workflows.
- This study assesses the impact of student note-writing on resident and attending physician documentation time.
Purpose of the Study:
- To evaluate the effect of integrating medical student documentation into electronic medical records (EMR) on physician time.
- To determine if student note authorship increases documentation burden for residents and attending physicians.
Main Methods:
- Analysis of 46,850 progress notes and histories/physicals from a pediatric hospital medicine service (Jan 2017-Mar 2023).
- EMR-recorded provider access times quantified note editing duration.
- Linear mixed effects models compared editing times for notes authored by residents, third-year (M3), and fourth-year (M4) medical students.
Main Results:
- Attending physicians' note editing time did not significantly differ for notes from residents, M3, or M4 students (approx. 9 minutes).
- Residents spent significantly less time editing M3 student notes (17.3 minutes) compared to authoring their own notes (40.2 minutes).
Conclusions:
- Integrating medical student documentation does not increase attending physician EMR time.
- Residents editing student notes suggests potential efficiency benefits.
- Student documentation is a sustainable educational practice that boosts engagement without increasing physician workload.
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