Barriers to Medical Students’ Electronic Health Record Access Can Impede Their Preparedness for Practice
Open accessAbstract
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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Previous research has typically examined isolated technologies or local contexts, offering fragmented insights into how students engage with dHealth more broadly.
“Furthermore, previous research has typically examined isolated technologies (eg, AI in radiology [1415], EHRs [16], or telemedicine [17]) or local contexts (eg, studies conducted in Canada [14], the United Kingdom [15], Vietnam [18], or Finland [19]), offering fragmented insights into how students engage with dHealth more broadly.”
From Evolving Medical Students’ Digital Health Perceptions and Intentions: Insights From a Prepandemic and Postpandemic Survey Study (2025) · cites this paper as [16]
Cites
Herrmann-Werner, A., Holderried, M., Loda, T., Malek, N., Zipfel, S., & Holderried, F. (2019) · JMIR Medical Informatics · doi:10.2196/12648 · Cited by 20 · see citing works
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Program Director Perceptions of Proficiency in the Core Entrustable Professional Activities
Pearlman, R. E., Pawelczak, M., Yacht, A. C., Akbar, S., & Farina, G. A. (2017) · Journal of Graduate Medical Education · doi:10.4300/jgme-d-16-00864.1 · Cited by 47 · see citing works
The Accelerating Change in Medical Education Consortium: Key Drivers of Transformative Change
Lomis, K. D., Santen, S. A., Dekhtyar, M., Elliott, V. S., Richardson, J., Hammoud, M. M., Hawkins, R., & Skochelak, S. E. (2021) · Academic Medicine · doi:10.1097/acm.0000000000003897 · Cited by 35 · see citing works
Self-citationHerrmann-Werner, A., Holderried, M., Loda, T., Malek, N., Zipfel, S., & Holderried, F. (2019) · JMIR Medical Informatics · doi:10.2196/12648 · Cited by 20 · see citing works
Ringeval, M., Raymond, L., Pomey, M.-P., & Paré, G. (2025) · Journal of Medical Internet Research · doi:10.2196/64804 · Cited by 4 · see citing works
- Authors
- Welcher, C. M., Hersh, W., Takesue, B., Stagg Elliott, V., & Hawkins, R. E.
- Affiliations
- American Medical Association (US)
- Oregon Health & Science University (US)
- Indiana University Indianapolis (US)
- V.S. Elliottis technical writer, Medical Education Outcomes, American Medical Association, Chicago, Illinois.
- Corresponding author
- Welcher, Catherine M.
- ORCID
- Hersh, William
- Venue
- Academic Medicine
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-01
- Volume
- 93
- Issue
- 1
- Pages
- 48-53
- ISSN
- 1040-2446 (ISSN-L)
- OpenAlex
- W2737945257
- Cited by
- 83
- References
- 1
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 13 · 2023: 8 · 2022: 12 · 2021: 14 · 2020: 10 · 2019: 11 · 2018: 6 · 2017: 1
- FWCI
- 10.51
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Academic Medicine (publishedVersion)
- PubMed (publishedVersion)
- IUScholarWorks (Indiana University) (submittedVersion, other-oa)
- Purdue University Indianapolis (Indiana University) (submittedVersion, other-oa)
- Funders
- School of Medicine, Indiana University
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Keywords
- electronic health records, medical students, clinical documentation, residency preparation, medical curriculum, experiential learning, medical education policy
- MeSH terms
- Clinical Competence, Documentation, Education, Medical, Humans, Problem-Based Learning, Access to Information, Electronic Health Records
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