Date of Award

January 2013

Document Type


Degree Name

Doctor of Philosophy (PhD)


Teaching & Learning

First Advisor

Myrna R. Olson


The purpose of this study was to determine the opinions of nurse educators in the state of North Dakota (ND) who were using the academic Electronic Health Record (EHR) known as SimChart. In this dissertation research study, factors that either hindered or facilitated the introduction of SimChart in nursing programs in ND were examined. Additionally, opinions were sought from nurse educators regarding whether or not SimChart contributed to student learning.

Seventy-five nurse educators from the state of ND participated in this mixed-methods study. E-mail addresses were obtained through website searches, and links to Qualtrics® surveys were e-mailed in three separate phases, using Delphi technique. The Phase 1 survey contained open-ended questions, encouraging nurse educators to express their views about factors that hindered or facilitated SimChart's implementation, and their views about whether SimChart facilitated or hindered student learning. The Phase 2 survey contained a Likert-type scale developed from instructors' responses in Phase 1. The Phase 3 survey asked nurse educators to respond to nurse educator ratings of hindrances and facilitators from Phase 2.

Qualitative data analysis was accomplished through NVivo software and an expert consultant review. Phase 2 and 3 data analysis was accomplished using SPSS® 20.

Data analyses confirmed that SimChart's adoption was facilitated by funding, educational efforts, opinions of colleagues throughout the state who agreed to purchase the product, and nurse educator "champions." SimChart's adoption was hindered by the amount of nurse educator time involved and the product's lack of modifiability. SimChart facilitated student learning in regard to navigating an EHR, collecting and entering data in an EHR, and how an electronic health record is organized. Hindrances to learning, while few were expressed, included the time that students needed to search through the academic EHR to become familiar with the software and find patient information.

Knowledge about facilitators for academic EHR adoption may be useful when considering forthcoming innovations in nursing education. Recommendations include incorporating academic EHRs into nursing education, ensuring adequate nurse educator development time and teaching/learning strategies when incorporating academic EHRs. Nurse educator efforts for implementing newer technologies, including academic EHRs should be recognized and remunerated.