Choi Mona, Lee HyeongSuk, Park Joon Ho
College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea.
Seoul Women's College of Nursing, Seoul, Republic of Korea.
Nurse Educ Today. 2018 Feb;61:112-119. doi: 10.1016/j.nedt.2017.11.018. Epub 2017 Nov 21.
The academic electronic medical record (AEMR) system is applied with the expectation that nursing students will be able to attain competence in healthcare decision-making and nursing informatics competencies. However, there is insufficient evidence regarding the advantage of applying mobile devices to clinical practicum.
This study aimed to examine the effect of an experiment that introduced a mobile AEMR application for undergraduate nursing students in their practicum.
A quasi-experimental design was used. The subjects were 75 third-year nursing students enrolled in clinical practicum and were divided into an experimental (practicum with AEMR) and a control (conventional practicum) group. Nursing informatics competencies, critical thinking disposition, and satisfaction with clinical practicum were measured before and after the clinical practicum for each group. The usability of the AEMR application was also examined for the experimental group after the experiment.
After the experiment, the experimental group showed a significant increase in the informatics knowledge domain of nursing informatics competencies in the post-test. The difference in critical thinking between the experimental and control groups was not statistically significant. Regarding satisfaction with the clinical practicum, the experimental group exhibited a significantly higher level of satisfaction in "preparation of a diagnostic test or laboratory test and understanding of the results" and "nursing intervention and documentation" than the control group. Students who participated in the practicum using the AEMR application considered it useful.
The AEMR application was an effective educational method for practicing the immediate documentation of students' observations and interventions and was available at the patients' bedsides. To improve critical thinking, it is necessary to apply a variety of approaches when solving clinical problems.
学术电子病历（AEMR）系统的应用旨在使护理专业学生能够在医疗决策和护理信息学能力方面达到胜任水平。然而，关于将移动设备应用于临床实习的优势，证据不足。
本研究旨在考察一项针对本科护理专业学生临床实习引入移动AEMR应用程序的实验效果。
采用准实验设计。研究对象为75名参加临床实习的三年级护理专业学生，分为实验组（使用AEMR进行实习）和对照组（传统实习）。在每组临床实习前后，测量护理信息学能力、批判性思维倾向以及对临床实习的满意度。实验结束后，还对实验组的AEMR应用程序的可用性进行了考察。
实验结束后，实验组在后测中护理信息学能力的信息学知识领域有显著提高。实验组和对照组在批判性思维方面的差异无统计学意义。在对临床实习的满意度方面，实验组在“诊断检查或实验室检查的准备及结果理解”和“护理干预与记录”方面的满意度显著高于对照组。参与使用AEMR应用程序实习的学生认为该程序有用。
AEMR应用程序是一种有效的教育方法，可用于学生即时记录观察结果和干预措施，且可在患者床边使用。为提高批判性思维，在解决临床问题时需要采用多种方法。
