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Acad Med. 2018 Jan;93(1):48-53. doi: 10.1097/ACM.0000000000001829.

Barriers to Medical Students' Electronic Health Record Access Can Impede Their Preparedness for Practice.

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C.M. Welcher is senior policy analyst, Medical Education Outcomes, American Medical Association, Chicago, Illinois. W. Hersh is professor and chair, Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, Oregon. B. Takesue is assistant professor of clinical medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. V.S. Elliott is technical writer, Medical Education Outcomes, American Medical Association, Chicago, Illinois. R.E. Hawkins is vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois.


Medical students need hands-on experience documenting clinical encounters as well as entering orders to prepare for residency and become competent physicians. In the era of paper medical records, students consistently acquired experience writing notes and entering orders as part of their clinical experience. Over the past decade, however, patient records have transitioned from paper to electronic form. This change has had the unintended consequence of limiting medical students' access to patient records. This restriction has meant that many students leave medical school without the appropriate medical record skills for transitioning to residency.In this article, the authors explore medical students' current access to electronic health records (EHRs) as well as policy proposals from medical societies, innovative models implemented at some U.S. medical schools, and other possible solutions to ensure that students have sufficient experiential learning opportunities with EHRs in clinical settings. They also contend that competence in the use of EHRs is necessary for students to become physicians who can harness the full potential of these tools rather than physicians for whom EHRs hinder excellent patient care. Finally, the authors argue that meaningful experiences using EHRs should be consistently incorporated into medical school curricula and that EHR-related skills should be rigorously assessed with other clinical skills.

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