Using an electronic health record to develop nursing process skills and critical thinking: A qualitative study about the students' experiences and behaviors.

摘要

Preparation of the contemporary nursing graduate requires an educational approach that harnesses the opportunities of the information age and encourages critical, creative thinking. Effective health care will mirror quality innovations in nursing education that promote these knowledge worker competencies. Thus, the purpose of the study was to describe the experiences and behaviors of beginning nursing students when learning nursing process while using an electronic health record with embedded decision support. Case study design was used to yield descriptive data in a naturalistic paradigm of inquiry. The setting for the study was a Midwestern University School of Nursing equipped with state-of-the art information technology. A criterion, purposive sample was obtained. Informants were members of a seminar group of eight students who were led by an experienced nursing instructor. Data were obtained from observations of the seminar group when using an electronic health record, interviews with students about the experiences and evaluation of student care plans that were generated when using the technology. Data collection and simultaneous analysis took place over the 16 week semesters during and following the teaching innovation. An inductive content analysis method was utilized to accomplish data reduction and synthesis. The following two foundational themes emerged with the second theme building on the first: (a) Techno-savvy students and teacher, simulated technology and data rich case studies: A valuable hybrid seed for learning; and (b) Seeing, hearing and doing: A catalyst for application and spontaneous interaction. The overarching, concluding theme goes as follows: Honing the data gatherer and data user roles with an electronic health record: An authentic, learner-centered experience. The findings suggest that the technology-based activity (a) was a learner-centered activity enjoyed by students, (b) met their immediate learning needs, (c) facilitated application of nursing therapeutics, and (d) promoted hands-on, active learning with some opportunities to develop critical thinking. Further study is needed to (a) explore other opportunities for enhancing critical thinking, and (b) measure learning outcomes with similar technology-based, learner-centered activities.