Teaching beliefs and practices and the use of electronic health records in nursing education: A collective case study

Information technology is essential to improve quality of care within the USA healthcare system. The Institute of Medicine recommended an integration of Electronic Health Records (EHR) into education to establish a foundation for evidence-based practice. In 2001, the University of KansasSchool of Nursing (SON) began a collaboration with an EHR vendor to integrate the EHR into the nursing curriculum through a project called S&barbelow;imulated E&barbelow;lectronic - hE&barbelow;alth D&barbelow;elivery S&barbelow;ystem (SEEDS). As part of a larger study to evaluate SEEDS, this study explored teaching beliefs and practices of educators using EHR in the classroom to determine themes and patterns of the beliefs and practices. An exploratory, descriptive research design and a collective case study method were used to capture the teaching beliefs of seven SEEDS educators. Repeated open-ended interviews, direct and video-taped observations, and curriculum documents comprised the data.; Results of the study indicated that teaching beliefs are an important concept in teaching and educators seek consistency between their belief and practices in all teaching media including EHR. The substance of teaching beliefs themes was organized on a constructivism-objectivism continuum to illustrate patterns and contrasts. Constructivist beliefs, which were the main beliefs' structure of participants, focus on the learners' ownership of knowledge, extracting experiences from students' lives, using a liberating teaching style, and creating a sharing learning environment, and were related to EHR use. Objectivist beliefs focused on the teachers' ownership of knowledge, using instructional approach, and control over the context of learning. Constructivist teachers had a futuristic look toward using EHR as a tool to prepare students for automated healthcare settings, whereas, objectivist teachers did not. Constructivist teachers used EHR to enhance students' learning through interaction and dialogue, whereas objectivist teachers did not. In addition to teaching beliefs, the design of the EHR technology and the classroom setting fostered constructivist principles of contextual, experiential, liberating and interactive learning. Implications include supporting educators to adopt constructivist beliefs to guide their practices, especially when introducing EHR in education to prepare RNs to provide evidence-based health care in future technologically enriched settings. Future education/business partnerships are recommended to successfully integrate EHR in education.