Nursing education and training on electronic health record systems: An integrative review

Aim: This integrative review aimed to synthesize evidence pertaining to interventions that have been used to facilitate nurse education and training on electronic health records. Background: Inadequate education and training can threaten the adoption of electronic health records and negatively impact the quality of nursing documentation. A review of the literature may help facilitate the development of evidence-based interventions for nursing education and training on electronic health records. Design: An integrative review framework was used to address the research question: What is the available evidence to inform best practices for nursing education and training on electronic health records? Methods: A systematic search was conducted in five databases: the Cumulative Index to Nursing and Allied Health Literature, Scopus, PubMed, CBCA Education, and ProQuest Education Database. Included articles were peerreviewed studies, published in English, in which nurses participated in an electronic health record education or training intervention. Results: Fifteen articles, from a search conducted between 2010 and 2020, were reviewed. Findings identified a shift from classroom learning towards blended approaches for nursing education and training on electronic health records, incorporating methods such as e-learning, peer coaching, and simulation. Ongoing staff engagement is needed to develop interventions that allow nurses to integrate electronic health records into their daily workflows. Higher quality studies and more meaningful assessment of learning outcomes are needed to identify the most effective interventions to incorporate in blended learning strategies. Conclusions: Consensus in the reviewed literature indicated that electronic health record education and training for nurses should be multipronged and targeted to nurses' clinical workflows. Key findings of this review identified a shift from classroom-based learning towards blended approaches for electronic health record education and training. Blended approaches often incorporated non-traditional methods that could support interactive and workflow-based content. These included e-learning, nurse superusers or peer coaches, and simulation training. The findings of this review also highlighted the need for early and ongoing involvement of frontline nurses during electronic health record education and implementation. However, more rigorous studies that assess both patient and organizational outcomes are needed to identify the most effective "cocktail" of blended learning strategies.