Capturing Nursing Students’ Cognitive Challenges and Efforts in EHR-related Tasks: Findings from a Thematic Analysis

Abstract

Electronic health record (EHR) systems are medical databases designed to standardize patient and medical information as well as aid care providers in clinical decisions. Despite such useful intentions, the combination of rapid incorporation and lack of user testing of the EHR systems resulted in increased medical errors, user stress and burnout. This prompted broad investigations into the issues related to the usability of the EHR applications. However, limited research has studied user’s cognitive challenges and efforts, which are a more fundamental aspect than the usability of technical interface. Especially, there has been lack of attention to a novice user group, that is a nursing student. The current paper provides findings from interviews with nursing students with respect to their challenges and efforts while conducting critical nursing tasks. Findings from the thematic analysis include nursing students’ challenges with interpreting patient data in different modalities (e.g., audio, visual, tactile), recalling numerical values of patient data, and correcting discovered errors in a timely manner. These findings broaden the current understanding of the EHR-related issues into the underlying cognitive mechanism under specific nursing task contexts. Future efforts are needed to address the nursing students’ cognitive challenges with human-centered technical solutions and work design.