Award Date


Degree Type


Degree Name

Doctor of Philosophy (PhD)



First Committee Member

Lori Candela

Second Committee Member

Catherine Dingley

Third Committee Member

Carolyn Yucca

Fourth Committee Member

Joseph Morgan

Number of Pages



The use of health information technology has been shown to have positive effects on patient outcomes and provider efficiency. New nurses make more than half of the 7 million life-threatening medication errors that occur each year, and electronic health records (EHRs) have been shown to significantly reduce these errors. Nurses now are expected to enter practice with a solid foundation in health information technology and the use of the EHR. Unfortunately, the vast majority of nursing schools do not specifically train their students in effective EHR utilization. Academic EHRs (AEHRs) are software packages with learning features that can be incorporated in the classroom, simulation, and skills labs. Existing studies have only examined student preferences for their use, with little or no data on improvement in quantifiable outcomes. The purpose of this study was to investigate if the use of an AEHR improved self-efficacy, reduced anxiety, and enhanced competence compared to a traditional PowerPoint presentation on EHR usage. Bandura’s social cognitive theory was the guiding framework of this study.

This study used a quasi-experimental design with first-semester students enrolled in a Baccalaureate of Science in Nursing (BSN) program. The control group received EHR instruction in a traditional 1-hour PowerPoint lecture. The intervention group received a 1-hour instructional session using and navigating in an AEHR (Lippincott DocuCare). Pre- and postinstruction measures and surveys showed undergraduate nursing students who received hands-on AEHR instruction had increased self-efficacy, less anxiety, and increased competency compared to peers who received the traditional instruction. The results of this study indicate that the use of an AEHR in nursing curricula may be a more effective teaching strategy to improve students’ self-efficacy, anxiety, and competency.


Academic Electronic Health Record; Competency; Nursing Curriculum; Nursing Education; Nursing Informatics; Technology


Education | Nursing

File Format


Degree Grantor

University of Nevada, Las Vegas




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