Charting Before the Bedside: Integrating an Academic Electronic Health Record Into a Nursing Curriculum
Student Name
Master of Science in Nursing Program, Aspen University
N582: Teaching Strategies in Nursing Education
Instructor Name
Month Day, Year
Charting Before the Bedside: Integrating an Academic Electronic Health Record Into a Nursing Curriculum
In a composite baccalaureate program, most clinical partners no longer allow students to document in the live electronic health record. Students may view a patient's chart but write their assessments on paper worksheets that no one else reads, and some sites restrict even viewing access. Graduates report that the first weeks of employment are consumed by learning to find information and document in a system they have barely used, and new graduate orientation staff agree. The program's technology committee is considering an academic electronic health record, a teaching version of an EHR populated with fictional patients, for use across the curriculum.
This paper evaluates that technology as a teaching strategy. It describes what an academic EHR offers, reviews evidence on EHR education and on students' experiences learning documentation, proposes where and how to integrate it, and addresses cost, faculty preparation and evaluation.
What an Academic EHR Offers
An academic EHR looks and behaves like a clinical system but contains simulated patient records that faculty can build and modify. Students can review histories, trend vital signs and laboratory values, read provider notes, document assessments, administer medications against a medication administration record and write care plans and handoff notes, all without risk to real patients. Faculty can see what each student documented, compare it with an expected standard and provide feedback on specific entries, something impossible with paper worksheets. The same simulated patient can appear in the classroom, the skills laboratory and simulation scenarios, so that documentation becomes part of every learning activity rather than a separate skill.
The technology also supports specific teaching strategies. Faculty can release new results or provider orders into a record between class sessions, so that students must recognize a change and respond, which mirrors the vigilance expected in practice. Students can compare their documentation of the same simulated assessment and discuss why entries differ. And because the platform records what students opened and when, faculty can see whether a student reviewed the relevant laboratory trend before documenting a concern, information that paper worksheets never reveal.
What the Evidence Suggests
The evidence base for EHR education is modest but consistent in direction. In an integrative review of 15 studies of nurses' education and training on electronic health records, Ting et al. (2021) found a shift from classroom teaching toward blended approaches combining e-learning, peer coaching or superusers and simulation, and concluded that EHR education should be multipronged and tied to nurses' actual clinical workflows. They also noted the need for more rigorous studies measuring learning and patient outcomes. For students, qualitative evidence highlights the gap between the academic and clinical settings. In focus groups with 21 nursing students who had completed an academic EHR documentation course before a nursing home placement using the same system, Reierson et al. (2025) found that students valued teacher guidance and peer learning in the academic setting, but during placement often felt on their own and worried about patient safety, and that learning in clinical settings had gaps and inaccuracies. Students emphasized both learning in the academic setting and receiving feedback in clinical practice.
Two design implications follow. First, the academic EHR should be woven into realistic workflows, such as receiving a handoff, reviewing overnight trends and documenting a reassessment, rather than taught as a series of screens. Second, the academic system does not replace guided documentation in clinical settings where it is permitted; it prepares students to make better use of it.
Integration Across the Curriculum
The table outlines how the academic EHR could be introduced and built on across four semesters.
| Semester | Course | Use of the academic EHR |
|---|---|---|
| First | Health assessment | Navigate the record; document a complete head-to-toe assessment on a simulated patient; instructor feedback on each entry |
| Second | Medical-surgical nursing I | Pre-clinical preparation from a simulated chart; trend vital signs and laboratory values; medication administration record practice |
| Third | Medical-surgical nursing II and simulation | Unfolding patients whose records change between class sessions; documentation during simulation scenarios; handoff notes |
| Fourth | Leadership and transition | Manage a simulated assignment of four patients; prioritize from chart data; document an escalation and a rapid response |
Two features make the integration effective. The same small group of simulated patients recurs across courses, so students see how a record grows over an admission and learn to read it as a story. And feedback is built in: in the first two semesters, faculty or trained teaching assistants review a sample of each student's documentation using a short rubric focused on accuracy, completeness, objectivity and timeliness, and students revise entries in response.
Cost, Faculty Preparation and Evaluation
Academic EHR platforms are typically licensed per student, and the program must weigh the cost against the time saved in orientation and the value of documentation practice. Faculty need preparation, both to use the system and to build patient records, which takes more time than most expect. Using technology to support learning is among the competencies expected of nurse educators (Halstead, 2019), and a small team of faculty champions, with release time in the first year, can build a shared library of simulated patients. Clinical partners should be consulted so that the academic system reflects the documentation conventions students will meet.
The program should evaluate the technology on outcomes that matter. Documentation rubric scores can be compared across semesters, student confidence with the EHR can be surveyed before and after, and hiring partners can be asked whether new graduates need less EHR orientation. Following the review's call for more meaningful outcomes, the program might also examine whether students using the academic EHR identify concerning trends in simulated records more reliably than earlier cohorts.
Conclusion
When clinical partners restrict students' access to the electronic health record, students lose practice with one of the central tools of nursing work. An academic EHR restores that practice safely and lets faculty see and respond to what students document. The evidence supports blended, workflow-based EHR education and shows that students value guided academic learning but still need feedback in clinical settings. Integrated deliberately across the curriculum, with prepared faculty and meaningful evaluation, an academic EHR can help graduates arrive at their first job able to read and write the record their patients depend on.
References
Halstead, J. A. (Ed.). (2019). NLN core competencies for nurse educators: A decade of influence. Wolters Kluwer.
Reierson, I. Å., Mofossbakke, R. G., & Solli, H. (2025). Nursing students' perspectives on learning electronic health record documentation in an academic setting and during clinical placement: A qualitative study. BMC Nursing, 24, Article 764. https://doi.org/10.1186/s12912-025-03320-5
Ting, J., Garnett, A., & Donelle, L. (2021). Nursing education and training on electronic health record systems: An integrative review. Nurse Education in Practice, 55, Article 103168. https://doi.org/10.1016/j.nepr.2021.103168
How this N 582 Module 7 example is structured
Aspen does not publish N582 module prompts, so check your classroom for the exact instructions. This example states the teaching problem, describes the technology, reviews the evidence and draws design implications, lays out integration across four semesters in a table, and addresses cost, faculty preparation and evaluation.
N582 Module 7 questions, answered
What does N582 Module 7 usually ask for?
Aspen's N582 description includes integrating educational technology into the learning environment, so a paper evaluating and planning the integration of one technology is a typical module task. Check your classroom for the exact focus.
What is an academic electronic health record?
A teaching version of an EHR containing simulated patient records, which students can use to practice finding information, documenting care and administering medications without risk to real patients.
Does an academic EHR replace charting in clinical settings?
No. It prepares students to use clinical systems well. Where clinical partners allow supervised student documentation, that experience and the feedback that comes with it remain important.
Write yours, or have the desk draft it
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