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SCHOLAR is a QUERI-partnered evaluation initiative (PEC 21-280) titled “Strengthening Cerner Implementation for Health Professions Trainees to Optimize Learning and Reinforce Veteran Care (SCHOLAR)”. SCHOLAR’s objective is to understand factors associated with effective EHR learning and positive health professions trainees (HPT) experiences, in collaboration with its operational partner, VA’s Office of Academic Affiliations (OAA).
This project is co-led by Multiple Principal Investigators, Dr. Seppo Rinne at VA Bedford Healthcare System, Dr. George Sayre at VA Puget Sound Healthcare System, and Dr. Ellen Ahlness at VA Puget Sound Healthcare System.
Findings from this quality improvement evaluation are used to develop effective EHR learning and training practices that enhance EHR learning for HPTs. VA is the nation’s largest provider of clinical training, annually educating over 120,000 HPTs. HPTs play a crucial role in delivering high quality and efficient Veteran care - HPTs are involved in the care of about 35% of all Veterans in VA - and VA looks to HPTs as a pipeline for recruiting high quality health professionals to VA employment.
From 2021 to 2024, SCHOLAR focused on facilitators of EHR learning and positive clinical training experiences at sites undergoing VA’s EHR transition. EHR transitions are disruptive endeavors; HPTs are particularly vulnerable to such transitions’ adverse effects, as they depend on well-functioning health systems to learn and deliver care. VA sites undergoing EHR transition must minimize disruptions to HPT care provision. Leveraging longitudinal surveys and interviews with HPTs, site leaders, and clinical supervisors at early EHR modernization (EHRM) and non-EHRM sites, we identified wide variation in EHR learning experiences, with negative EHR learning experiences decreasing HPT interest in pursuing VA careers. In collaboration with OAA, change management strategies were implemented to improve EHR learning experiences across early sites.
In 2025, we shift to identify systems and practices that optimize or hinder HPT EHR learning, regardless of EHR in use. We will continue to collaborate with OAA to establish acceptability and feasibility of recommendations. Our findings highlight the need for effective HPT EHR learning systems and practices that mitigate negative EHR impacts and ensure quality training HPT training that encourages HPTs to seek a career in the VA.
