EdEHR Blog
Research Confirms the Case for Early, Structured EHR Training in Nursing Education
March 5, 2026 · By Bryan Gilbert
A paper published this month in JMIR Nursing adds to a growing body of research documenting a persistent gap in how nursing programs prepare students to work with electronic health records. The study — Castonguay, Hegg-Deloye, Paré, and Etindele Sosso (2026) — surveyed 136 nursing students at the Université de Montréal across three cohorts and found that students rated their EHR training coverage as low across all years of the program.
The finding is consistent with what researchers have been observing for some time.
A Pattern the Research Has Been Tracing
In 2019, a team of Canadian educators and informatics researchers — Rees, Morrison, Ahuja, Currie, and colleagues from BCIT, Douglas College, UBC, UVic, and partner institutions — published foundational work on the development of an interprofessional educational EHR grounded in Canadian nursing competency frameworks. Their work identified that no existing platform adequately met the needs of Canadian health sciences education, and established the case for purpose-built, pedagogy-first tools aligned with CASN entry-to-practice competencies.
In 2021, Kleib, Jackman, Duarte Wisnesky, and Ali published a mixed-methods pilot study in JMIR Nursing examining what actually happens when undergraduate nursing students use a simulated academic EHR. Their findings were instructive: self-reported informatics knowledge scores rose significantly after one month of use, with a large effect size. Documentation accuracy improved progressively as students worked through successive case scenarios. Crucially, both students and educators agreed that skills developed in one simulated EHR transfer to other platforms — the goal isn't system familiarity, it's foundational competence.
The Kleib study also surfaced something important about what makes these interventions work: timely, non-punitive feedback was among the most valued features for both students and faculty. Students who had access to guided orientation found the platform far more approachable. And 92% expressed satisfaction with the ability to access the system at any time, from any location, at their own pace. Repeated, progressive exposure across the curriculum — rather than a single encounter — was what students and faculty both recommended.
The 2026 Castonguay paper arrives in that context. Its finding that third-year students showed higher EHR proficiency than first-years sounds like progress, but the authors note that this difference appears to come from incidental exposure during clinical placements rather than structured curricular preparation. The gap isn't closing by design. The authors call for targeted curricular reforms aligned with CASN and OIIQ guidelines, and recommend a pretest-posttest evaluation design to measure whether those reforms actually work — a reasonable ask for any program building an evidence base for institutional change.
What This Means for Francophone Programs
The Castonguay study was conducted at the Université de Montréal, the largest nursing faculty in Quebec and the French-speaking world. That context matters. Nursing practice in Quebec, Northern Ontario, New Brunswick, and across French-speaking Canada happens in French. Programs preparing students for that practice need tools that work in French — not as an afterthought, but as a functional part of the learning environment.
EdEHR is available in both English and French. The French-language interface has been developed and refined in direct collaboration with francophone educators, including the laboratory technicians at Laurentian University's francophone nursing program in Sudbury, who have used the platform with students and contributed meaningfully to improving it.
What It Looks Like in Practice
In the fall of 2025, Line Plante, Stephanie Kramp, and Sarah Bonin — laboratory technicians from Laurentian's francophone nursing program — moved their program from paper charting to EdEHR. They did this while simultaneously relocating their simulation labs and continuing to teach full schedules.
In under two months, they had built more than 50 case studies and lesson plans, refined French-language content across the platform, and had over 250 students actively practicing medication administration. In their endorsement letter, they described what drew them to EdEHR: its Canadian origin, its similarity to their local hospital's EHR system, the French-language interface, and the ability to work directly with the people building it — sharing feedback that became real improvements.
That last point reflects something about how EdEHR works. The platform was developed through collaboration with Canadian nursing and health sciences educators from the beginning, and that relationship continues. Faculty who use EdEHR aren't adopting a fixed product — they're working with a team that listens.
For Programs Navigating Curriculum Revision
If your program is in the middle of a curriculum revision — or anticipating one — and you're thinking about how to build structured EHR competency into your lab curriculum, the research points toward a few practical requirements: progressive exposure across the program, accessible anytime practice, timely feedback tools for faculty, and a platform that reduces rather than adds to administrative workload.
EdEHR integrates with Moodle, Canvas, D2L/Brightspace, and other LMS platforms, which means course setup, student rosters, and activity management can flow through the systems your institution already uses. The pretest-posttest design the authors recommend is well-suited to a structured platform environment — where the intervention itself is documented, and faculty can observe and assess student progress across a sequence of activities.
We offer a free pilot for programs that want to explore EdEHR before making any commitment — a chance to work through the platform, build a case study or two, and see whether it fits what you're trying to do.
If you'd like to talk through what that might look like for your program, we'd be glad to hear from you.
References
Castonguay A, Hegg-Deloye S, Paré G, Etindele Sosso F. Perceptions and Intentions of Nursing Students Regarding Digital Health: Cross-Sectional Study. JMIR Nursing. 2026;9:e77051. doi: 10.2196/77051
Kleib M, Jackman D, Duarte Wisnesky U, Ali S. Academic Electronic Health Records in Undergraduate Nursing Education: Mixed Methods Pilot Study. JMIR Nursing. 2021;4(2):e26944. doi: 10.2196/26944
Rees G, Morrison J, Ahuja K, Anthony J, Blanes N, Borycki EM, Bower L, Isaak C, Kruger R, Kushniruk A, Min J, Moore C, Visosky P, Currie L. Development of an Interprofessional Educational Electronic Health Record. Studies in Health Technology and Informatics. 2019;257:364–369. doi: 10.3233/978-1-61499-951-5-364