Kelly McGowan, Senior Applications Analyst at Juno Health, recently sat with our editorial team to discuss why most EHR training programs miss the mark, and what hospitals can do differently to maximize their investment, protect patient safety, and build a workforce that's truly confident in the system.
The following has been edited for length and clarity.
Q: Hospitals invest significantly in new EHR systems, yet staff adoption often lags behind expectations. What's going wrong with the way most organizations approach training?
McGowan: The instinct is to get everyone trained as quickly as possible, so hospitals tend to group unrelated roles into the same sessions and deliver the same generic content across the board. It feels efficient on paper, but it's counterproductive in practice. A lab technician sitting through a module on billing workflows isn't learning anything that will help them do their job. And a nurse who needs to master flowsheet documentation isn't getting what they need from a presentation designed for everyone.
Training has to be relevant and immediate. The more closely instruction maps to what a staff member will actually do the next time they open the EHR, the more likely they are to retain it. When content doesn't connect to someone's daily role, you lose their attention, and in a clinical setting, that loss of attention can ultimately put patients at risk.
The fix starts with separating roles. Nurses, physicians, pharmacy technicians, and other clinicians should each have dedicated sessions tailored to their specific workflows. Nurse training, for example, might emphasize documenting on flowsheets, while physician training focuses on dictation and problem-oriented notes. That kind of specificity is what makes training stick.
Q: Beyond role-specific content, how should hospitals rethink the structure and scheduling of EHR training to set clinicians up for success?
McGowan: Two things matter enormously here: how you teach and when you teach. Regarding the how: interactive, hands-on instruction will always outperform lectures and slideshows when it comes to clinical software. Immersing trainees in the EHR from the moment a session begins does more than build competency. It alleviates anxiety about the change, piques genuine interest in the system, and helps people absorb information in the context of doing, not just listening.
As far as the when; this one is often overlooked, and it's critical. The vast majority of clinicians are already working 12 or more hours a day and spending additional time outside of their shifts entering and analyzing EHR data. Tacking training onto the beginning or end of a shift compounds that fatigue. A tired clinician is not going to get the most out of a training session, and that has real implications for patient care.
Schedule training on a dedicated day off so staff members come in rested and ready to focus. Beyond that, it's worth monitoring session attendance carefully. Overcrowded classes and half-empty rooms both undermine the experience. The right balance ensures that vendor resources are used effectively and that every attendee gets real value from the time they've committed.
Finally, don't underestimate communication. When training schedules change (and they often do) staff need timely, accurate updates. Confusion about where to go, when to show up, or which session applies to their role is a quiet but significant source of friction. Keeping a full inventory of trainees and proactively sharing updates can go a long way toward preventing no-shows and misrouted participants.
Q: What does it take to ensure EHR competency doesn't stop at go-live, and what does long-term learning look like in practice?
McGowan: Go-live is not the finish line. It's the beginning of a much longer process of building real proficiency, and hospitals that treat initial training as a one-and-done event tend to struggle with sustained adoption.
Building muscle memory is essential. After a clinician completes their first EHR training, they need continued opportunities to practice new clicks, navigation paths, and functionality before those actions become second nature. That means investing in practical resources like training labs, devices available for practice, and budgeted overtime hours specifically designated for skill-building.
Subject matter experts, both within the organization and on the vendor side, are the backbone of that ongoing learning. Bringing your vendor trainers and internal nursing educators together to share knowledge creates a bridge between what the software can do and how it best supports your specific operational workflows. Appointing multiple internal SMEs who learn directly alongside the vendor, then coach other staff once the EHR is live, ensures that expertise is distributed across the floor, not concentrated in a single person who becomes a bottleneck.
And then there's measurement. Organizations need a system to track EHR competency over time. Tying evaluations to standard 30-, 60-, and 90-day new-hire check-ins is a natural starting point. But longer-term reporting can surface even deeper insights, including how long it takes individual staff members to complete specific tasks and what trends across a unit might signal a broader training need. That data tells you where to focus your next round of improvement.
Equally important: listen to your staff. Gathering direct feedback on both training effectiveness and system usability closes the loop. When clinicians feel heard and see their input reflected in how training evolves, they become partners in adoption, not just recipients of it.
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