Electronic Health Record Training in Medical Curricula: A Scoping Review (Preprint)

Abstract

<sec> <title>BACKGROUND</title> Electronic health records (EHRs) are now central to the practice of modern medicine, underpinning documentation, communication, and data exchange within digital health ecosystems. Competence in their use has therefore become a core professional requirement for medical graduates. Yet, EHR education in undergraduate medical curricula remains fragmented and unevenly implemented across institutions and regions. </sec> <sec> <title>OBJECTIVE</title> This scoping review aimed to map and synthesise published educational interventions that teach or assess EHR competencies in undergraduate medical curricula, identifying current practices, outcomes, and gaps to inform future curriculum design and policy development in the European context. </sec> <sec> <title>METHODS</title> The review followed the Joanna Briggs Institute (JBI) methodological framework and was reported in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. Searches were conducted in PubMed, Embase, Scopus, ACM Digital Library, and IEEE Xplore (January 2018 – May 2025), complemented by grey-literature searches in Google Scholar and ScienceDirect. Eligible studies described educational interventions involving undergraduate medical students that explicitly taught or assessed EHR use. Two reviewers independently screened and extracted data on learning outcomes, teaching methods, and assessment strategies. </sec> <sec> <title>RESULTS</title> Seventeen studies met inclusion criteria, comprising twelve from the U.S. and five from Europe. Across diverse settings, EHR education was found to be increasingly structured and competency-driven, with simulation-based learning, team documentation, and experiential strategies consistently associated with improved confidence and documentation quality. However, long-term outcomes, faculty readiness, and European-specific evidence remain limited. </sec> <sec> <title>CONCLUSIONS</title> EHR training is evolving into a fundamental component of medical education but lacks standardisation across institutions. Establishing open-access EHR simulation environments, embedding digital-health competencies within core curricula, and aligning assessment with Entrustable Professional Activities (EPAs) and the European Health Data Space (EHDS) are essential next steps to ensure a digitally skilled medical workforce. </sec>

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