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The role of cognitive and learning theories in supporting successful EHR system implementation training: a qualitative study

The role of cognitive and learning theories in supporting successful EHR system implementation training: a qualitative study. McAlearney, A. S., Robbins, J., Kowalczyk, N., Chisolm, D. J. & Song, P. H. Med Care Res Rev 69, 294–315 (2012).

OVERVIEW

This paper uses social cognitive theory, adult learning theory, key informant interviews and focus groups to make recommendations for seven best practices for EHR implementation training in healthcare organizations. The authors’ analyses suggest training programs must move beyond technical approaches to social and cultural factors for implementation success.

KEY FEATURES

To contribute to better learning outcomes and meaningful use of EHR systems, the authors give the following propositions:

Proposition 1: EHR system training programs should emphasize the positive potential of EHR systems to produce positive outcomes.

Proposition 2: EHR system training programs should incorporate observation and active learning activities.

Proposition 3: EHR training programs should identify positive role models, ex. champions, super-users, etc.

Proposition 4: EHR training programs should recognize an organization’s past experiences with IT implementation and encourage participants to reflect on these experiences.

Proposition 5: EHR training programs should take into account the characteristics and assumptions of the community of practice.

BOTTOM LINE

The seven proposed best practices stem from these propositions: Obtain organizational commitment to invest in training (Prop 1), Assess users’ skills and training needs (Prop 2), Select appropriate training staff (Prop 3), Match training to users’ needs (Prop 5), Use multiple training approaches (Props 2, 4, and 5), Provide training support throughout implementation (Prop 2).

COMMENTARY

This is a great paper that analyzes sociological and cultural factors within organizations to make recommendations on EHR implementation training. The authors use cognitive and adult learning theories for analysis and back up their recommendations with quotes and themes pulled from interviews and focus groups. This paper is well worth reading for the broad understanding of successful training practices and the factors that underlie them. 4/5 Checks.