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The ole o ield s udying p ac ices in imp o ing unde s anding
and skills o using elec onic medical eco ds among medical
eco ds and heal h in o ma ion s uden s
Muspa lin Halid1* , Beny Bina o Budi Susilo1
1Depa men o Medical Reco d and Heal h In o ma ion, Poli eknik Medica Fa ma Husada Ma a am, Ma a am, Nusa Tengga a Ba a ,
Indonesia
A icle in o Abs ac
In oduc ion
In he digi al e a, he use o heal h in o ma ion
echnology in heal h se ices has inc eased. The
de elopmen o in o ma ion echnology has a signi ican
impac on a ious sec o s, including he heal h sec o s
[1]. One impo an aspec o a mode n heal hca e sys em
is e icien and in eg a ed medical eco d managemen .
Heal h In o ma ion Sys em (HIS) plays a key ole in
managing pa ien da a secu ely, accu a ely, and quickly,
hus suppo ing be e medical se ices [2]. The e o e, an
in-dep h unde s anding o HIS is impo an o
p o essionals in he ield o medical eco ds, including
s uden s s udying in his ield [3]. Ad ances in
echnology ha e b ough abou new challenges ela ed o
da a secu i y and p i acy. The e o e, i is impo an o
heal hca e s uden s o ha e a s ong unde s anding o
hese issues, especially h ough hei Field S udy P ac ice
(FSP) in a Heal h Ca e Facili y (HCF). The a ge HCFs
whe e he FSP was implemen ed we e hospi als and
A icle his o y:
Recei ed 20 No . 2024
Accep ed 11 Feb. 2025
Published 14 Ap . 2025
Halid e al. J Med Edu De . 2025; 18(1): 87-95 Jou nal o Medical Educa ion De elopmen
Backg ound & Objec i e: Unde s anding he heo e ical concep s o Elec onic Medical
Reco ds (EMRs) alone is insu icien o p epa e s uden s o he p o essional wo ld. Th ough
Field S udy P ac ices (FSPs), s uden s gain a di ec unde s anding o EMR implemen a ion. The
aim o he s udy was o analyze he ole o FSPs in enhancing he skills o Medical Reco d and
Heal h In o ma ion (MRHI) s uden s in using EMR.
Ma e ials & Me hods: The s udy used a c oss-sec ional me hod conduc ed on s uden s o he
MRHI Depa men . The samples we e aken using a simple andom sampling echnique o aling
259 s uden s. Da a we e analyzed desc ip i ely, a Chi-squa e es and bina y logis ic eg ession.
Those me hods we e pe o med o de e mine he associa ion in s uden s' unde s anding and
skills o EMR wi h a signi icance le el o p- alue < 0.05 and Adjus ed Odds Ra io (AOR) wi h
95% Con idence In e al (CI).
Resul s: The s udy ound ha , he s uden s who had pe o med FSP in he hospi al we e 56.4%
and Communi y Heal h Cen e (CHC) was 43.6%. The e was a signi ican associa ion be ween
s uden s who pa icipa ed in he FSP a a Heal h Ca e Facili y (HCF) and a ious imp o emen s
in hei unde s anding and skills ela ed o Elec onic Medical Reco ds (EMR). Speci ically, he
s uden s showed inc eased unde s anding o he concep s and basic unc ions o EMR (p =
0.001), as well as echnical skills o using EMR (p = 0.001). They also demons a ed enhanced
knowledge o da a secu i y and p i acy (p = 0.002), and a be e unde s anding o wo k lows
and p ocedu es o using EMR (p = 0.041). Addi ionally, s uden s imp o ed hei unde s anding
o EMR sys em in eg a ion and in e ope abili y (p = 0.008) and showed compliance wi h EMR
e hics and egula ions (p = 0.001). They de eloped so skills in he p ac ice en i onmen (p =
0.018) and we e be e able o analyze and make decisions based on EMR da a (p = 0.025).
Conclusion: The su den s who pa icipa ed in FSP can imp o e hei unde s anding o
concep s, echnical skills, Da a secu i y, wo k lows, sys em in eg a ions, egula o y
compliances, so skills de elopmen s, and analy ical skills.
Keywo ds: elec onic medical eco d, ield s udy p ac ice, heal h in o ma ion sys em, medical
eco d and heal h in o ma ion s uden , heal h in o ma ic
*Co esponding au ho :
Muspa lin Halid, Depa men o
Medical Reco d and Heal h
In o ma ion, Poli eknik Medica
Fa ma Husada Ma a am, Ma a am,
Nusa Tengga a Ba a , Indonesia
Email: muspa [email protected]
O iginal A icle
How o ci e his a icle:
Halid M, Bina o Budi Susilo B. The
ole o ield s udying p ac ices in
imp o ing unde s anding and skills
o using elec onic medical eco ds
among medical eco ds and heal h
in o ma ion s uden s. J Med Edu De .
2025; 18(1): 87-95.
[ DOI: 10.61186/edcj.18.1.87 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Halid e al
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: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
88 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
Communi y Heal h Cen e s (CHCs). The main
di e ences we e in se ice complexi y, unc ionali y
ocus, and da a in eg a ion needs. Hospi als equi e mo e
complex EMR applica ions o suppo mul isec o al
se ices. CHCs highly ocused on p ima y heal h
se ices and communi y heal h epo ing based on
speci ic a eas [4]. FSP is one o he e ec i e lea ning
me hods o s uden s o apply he heo y hey ha e
lea ned in a eal con ex [5]. The implemen a ion o FSP
in medical eco d s uden s is designed o equip hem wi h
p ac ical knowledges, echnical skills, and p o essional
a i udes ha suppo wo k eadiness in he ield o heal h
in o ma ion managemen . Wi h hands-on expe ience,
s uden s a e expec ed o be able o con ibu e
signi ican ly in imp o ing he quali y o echnology-
based heal h se ices. In a heal hca e en i onmen ,
s uden s no only gain insigh in o medical p ocedu es
and pa ien in e ac ions, bu a e also aced wi h
challenges ela ed o da a secu i y [6]. Th ough his
p ac ical expe ience, hey can see i s -hand how pa ien
da a is managed and p o ec ed [7]. Fo medical eco d
s uden s, FSP p o ides a space o in e ac di ec ly wi h
HIS [8], ge o know a ious medical da a managemen
so wa e, and unde s and he wo k low and p ocedu es
in medical eco d managemen in heal h acili ies [9].
The need o an e icien and accessible medical eco d
sys em is inc easing. EMR has become an impo an
componen in he heal h in o ma ion sys em, eplacing
manual medical eco ds ha ha e been widely used in
a ious heal h acili ies [10]. EMR enables as e , mo e
accu a e, and secu e pa ien da a managemen , and
suppo s da a in eg a ion be ween heal hca e acili ies
[11]. Gi en i s impo an ole, mas e y and
unde s anding o EMR a e essen ial o p ospec i e
heal h wo ke s, including medical eco d s uden s [12].
Howe e , unde s anding EMR concep s heo e ically is
no enough o p epa e s uden s o ace he challenges o
he wo king wo ld [13]. Th ough FSP, s uden s can gain
a di ec unde s anding o he implemen a ion o EMR in
he ield [14]. The p ac ice p o ides an oppo uni y o
medical eco d s uden s o in e ac di ec ly wi h EMR
sys ems [15], lea n p ocedu es and wo k lows, and
unde s and he echnical and ope a ional challenges ha
may be aced in medical da a managemen [16].
FSP no only helps imp o e s uden s' echnical skills in
using EMR, bu also ein o ces hei unde s anding o he
impo ance o secu i y and con iden iali y o medical
da a [17]. In addi ion, hands-on p ac ice allows s uden s
o unde s and he egula o y and policy aspec s ela ed o
EMR as ou lined in he Regula ion o he Minis e o
Heal h o he Republic o Indonesia Numbe 24/2022
conce ning Medical Reco ds which desc ibes he
implemen a ion o EMRs and he secu i y also p o ec ion
o pa ien da a [18]. This s udy aims o analyze he ole
o FSP in imp o ing medical eco d s uden s' skills in he
use and managemen o EMR. Wi h his s udy, i is hoped
ha mo e in-dep h in o ma ion can be ob ained abou he
e ec i eness o he FSP in equipping medical eco d
s uden s wi h he necessa y unde s anding o ope a e and
u ilize EMR op imally.
Ma e ials & Me hods
Design and se ing(s)
The s udy used a c oss-sec ional me hod ha aimed o
unde s and and measu e he ole o FSP in imp o ing
Medical Reco d and Heal h In o ma ion (MRHI)
s uden s' unde s anding and skills owa ds EMR. This
me hod was chosen because i can desc ibe he impac o
FSP on s uden compe ence in unde s anding and
managing EMR. The s udy was conduc ed om
Feb ua y o Augus 2024, s a ing om p elimina y
s udies and da a collec ion o epo p epa a ion. The
s udy has unde gone he e hics commi ee p ocess and
ecei ed app o al om he E hics Commi ee o Heal h
Resea ch (ECHR) a he Ins i u e o Resea ch and
Communi y Se ice, Poli eknik Medica Fa ma Husada
Ma a am. The app o al is designa ed unde Numbe :
13/LPPM/ECHR/2024.
Pa icipan s and sampling
The popula ion in he s udy we e 857 s uden s o he
Depa men o MRHI a Poli eknik Medica Fa ma
Husada Ma a am, Lombok, Wes Nusa Tengga a
(WNT), Indonesia who pa icipa ed in he FSP a HCF,
namely hospi al and CHC. S uden s had comple ed FSP
a HCFs using EMR. The sampling echnique used
simple andom sampling ha me he inclusion and
exclusion c i e ia. Inclusion c i e ia included ac i e
s uden s in he MRHI depa men who ha e aken EMR
cou ses, ha e ca ied ou FSP a HCF, and a e willing o
pa icipa e in he s udy and p o ide in o ma ion
acco ding o esea ch needs. Exclusion c i e ia included
s uden s who we e inac i e o on lea e, s uden s who
s a ed hei s udies and had no aken EMR cou ses, and
we e no willing o pa icipa e in he s udy. Sample size
calcula ion was pe o med using he Sample Size
De e mina ion in Heal h S udies so wa e, e sion 2.0. A
ep esen a i e sample o 259 s uden s pa icipa ed in his
s udy.
[ DOI: 10.61186/edcj.18.1.87 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Halid e al
.
: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 89
Tools/Ins umen s
The ques ionnai e was designed as a checklis by he FSP
loca ion ield supe iso . This checklis is based on
s uden compe ency indica o s o EMR ha mus be
achie ed acco ding o FSP guidelines. S uden s who
pa icipa ed in he FSP we e ca ego ized in o wo g oups
based on hei loca ion: “hospi al” and “CHC”. Gende
was ca ego ized as “male” and “ emale. Measu emen s
ela ed o unde s anding he basic concep s and unc ions
o EMR we e ca ego ized as “unde s ood” o “less
unde s anding.” S uden s we e classi ied as ha ing
"unde s ood" i hey g asped he compe ency indica o s
ela ed o he de ini ion, pu pose, and di e ences
be ween manual and elec onic medical eco ds. They
also needed o iden i y pa ien da a, medical his o y, and
clinical da a in EMR. Con e sely, s uden s we e ma ked
as ha ing “less unde s anding” i hey did no ully
comp ehend some o hese indica o s. Technical skills in
using EMR we e ca ego ized as “skilled” o “less
skilled.” S uden s we e conside ed “skilled” i hey could
accu a ely inpu and upda e pa ien da a, mas e medical
da a sea ch and e ie al p ocedu es, and e ec i ely use
he main ea u es o EMR so wa e. These ea u es
include eco ding medical his o y, ea men , and
examina ion esul s in he EMR sys em. On he o he
hand, s uden s we e labeled as “less skilled” i hey did
no unde s and some o hese indica o s. Unde s anding
o da a secu i y and p i acy ela ed o EMR was
ca ego ized as “unde s ood” o “less unde s anding.”
S uden s we e classi ied as “unde s ood” i hey knew he
basic ules o da a secu i y in EMR, ecognized he
impo ance o main aining he con iden iali y o pa ien
da a, unde s ood au ho iza ion p ocedu es, and we e
awa e o limi ed access du ing EMR use. Addi ionally,
s uden s needed o be amilia wi h he s anda ds and
egula ions ela ed o medical da a secu i y. Con e sely,
s uden s we e ma ked as ha ing “less unde s anding” i
hey did no comp ehend some o hese indica o s.
Unde s anding o he wo k low and p ocedu es o using
EMR was ca ego ized as “unde s ood” o “less
unde s anding.” S uden s we e classi ied as
“unde s ood” i hey comp ehended how EMR is
in eg a ed in o he wo k low and ecognized he p ope
p ocedu es o eco ding medical da a and ensu ing da a
comple eness. Addi ionally, hey should be able o adap
o exis ing p ocedu es o minimize e o s in using EMR.
In con as , s uden s we e labeled as ha ing “less
unde s anding” i hey did no g asp some o hese
indica o s.
Unde s anding o EMR sys em in eg a ion and
in e ope abili y (o dinal scale) was ca ego ized as
“unde s ood” i s uden s know how EMR unc ions in
suppo ing da a in eg a ion, he impo ance o
in e ope abili y o pa ien da a ans e , able o explain
he bene i s and challenges o in eg a ing EMR da a
be ween HCFs, and “less unde s anding” i s uden s do
no unde s and some o hese indica o s. Compliance
wi h EMR e hics and egula ions (o dinal scale) was
ca ego ized as “unde s ood” i s uden s unde s and he
code o e hics o using EMR da a in heal h p ac ices,
ules ela ed o p o ec ing pa ien s' igh s o pe sonal
da a, unde s and policies and egula ions go e ning
access igh s and use obliga ions in EMR managemen ,
and “less unde s anding” i s uden s do no unde s and
some o hese indica o s. The abili y o de elop so skills
in he p ac ice en i onmen was ca ego ized as “capable”
o “incapable.” S uden s we e conside ed “capable” i
hey could communica e e ec i ely wi h supe iso s,
colleagues, eam membe s, and pa ien s o hei amilies
du ing p ac ice. They should also be able o wo k
collabo a i ely in mul idisciplina y eams o comple e
EMR- ela ed asks, adjus o he wo k cul u e, and ake
esponsibili y o he quali y and accu acy o he da a
managed in he EMR sys em. Addi ionally, s uden s
needed o comple e EMR- ela ed asks acco ding o
p ede e mined deadlines and manage ask p io i ies
e ec i ely in a dynamic wo k en i onmen . Con e sely,
s uden s we e labeled as “incapable” i hey did no
unde s and some o hese indica o s. The abili y o
analyze and make decisions based on EMR da a was
ca ego ized as “capable” o “incapable.” S uden s we e
deemed “capable” i hey could analyze epo da a om
EMR o assis in making medical o adminis a i e
decisions. They should unde s and how o use EMR da a
o suppo diagnosis, ea men , and ca e planning.
Addi ionally, s uden s needed o ecognize po en ial
e o s in he da a and unde s and how o co ec hem o
imp o e se ice quali y. Con e sely, s uden s we e
labeled as “incapable” i hey did no comp ehend some
o hese indica o s. Be o e he ins umen was dis ibu ed
o he subjec s, he alidi y was es ed using he Pea son
p oduc -momen es , wi h a signi icance le el o p- alue
< 0.05. The gende a iable has a co ela ion coe icien
o 0.575 ( alid). The measu emen o s uden s'
unde s anding o EMR who ollow FSP has a co ela ion
coe icien o 0.792 ( alid). Unde s anding he basic
concep s and unc ions o EMR has a co ela ion
coe icien o 0.571 ( alid). Technical skills in using
EMR ha e a co ela ion coe icien o 0.644 ( alid).
[ DOI: 10.61186/edcj.18.1.87 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Halid e al
.
: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
90 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
Unde s anding o da a secu i y and p i acy has a
co ela ion coe icien o 0.524 ( alid). Unde s anding o
he wo k low and p ocedu es o using EMR has a
co ela ion coe icien o 0.532 ( alid). Unde s anding o
EMR sys em in eg a ion and in e ope abili y has a
co ela ion coe icien o 0.641 ( alid). Compliance wi h
EMR e hics and egula ions has a co ela ion coe icien
o 0.492 ( alid). The abili y o de elop so skills in he
p ac ice en i onmen has a co ela ion coe icien o
0.593 ( alid). Analyzing and making decisions based on
EMR da a has a co ela ion coe icien o 0.440 ( alid).
Each a iable has an able alue o 0.138. The
ques ionnai e was es ed o eliabili y be o e being used
in he s udy. Acco ding o Pallan (2020), an ins umen
wi h a C onbach's Alpha alue abo e 70% is conside ed
eliable and sui able o measu ing esea ch a iables
[19]. The esul s o he ins umen eliabili y es
e ealed ha he C onbach's alpha alue was 0.723 o
72%.
Da a collec ion me hods
Da a we e collec ed by dis ibu ing ques ionnai es
di ec ly o s uden s a e hey comple ed he FSP. P io
o comple ion, s uden s we e gi en in o med consen and
an explana ion o he pu pose o he s udy, and da a
con iden iali y was gua an eed. Da a collec ion las ed o
wo weeks o ensu e ha he numbe o esponden s was
su icien and he da a ob ained was a ied. To educe
he isk o bias in he sampling p ocess, he au ho s lis ed
he popula ion c i e ia as s udy subjec s based on he
inclusion and exclusion c i e ia.
Da a analysis
The da a we e analyzed using Mic oso Excel and he
S a is ical Package o he Social Sciences (SPSS)
e sion 26.0. Da a we e analyzed desc ip i ely,
including equency dis ibu ion and pe cen ages o
esponden s' answe s ega ding hei unde s anding o
EMR. In addi ion, he Chi-squa e es and Bina y
Logis ic Reg ession we e conduc ed o de e mine he
associa ion be ween pa icipa ion in he FSP a HCF and
he imp o emen o s uden s' unde s anding and skills in
managing EMR. A signi icance le el o p- alue < 0.05
was used. The dep h o he associa ion be ween he
a iables was u he e iewed h ough he Adjus ed
Odds Ra io (AOR), wi h a 95% Con idence In e al (CI).
Resul s
Table 1 e eals ha an almos equal pe cen age o males
(51%) and emales (49%) pa icipa ed in he FSP. The
majo i y o s uden s pa icipa ed in FSP in hospi als
(56.4%), while 43.6% pa icipa ed in CHCs. This
indica es ha mo e s uden s a ended FSP a seconda y
HCF. Table 2 shows ha he e was a signi ican
associa ion be ween FSP s uden s pa icipa ing a HCF
in imp o ing s uden s' unde s anding o he basic
concep s and unc ions o EMR (p < 0.001), imp o ing
echnical skills in using EMR (p < 0.001), unde s anding
o da a secu i y and p i acy (p < 0.001), and
unde s anding o EMR wo k low and usage p ocedu es
(p < 0.001).
Table 1. F equency dis ibu ion o s uden s who pa icipa ed in
FSP
Va iables
n
%
Gende
Male
127
49.0
Female
132
51.0
Following FSP
Hospi al
146
56.4
CHC
113
43.6
No e: Desc ip i e analysis was conduc ed o see he dis ibu ion o pa icipan s.
Abb e ia ions: n, numbe o pa icipan s ; %, pe cen age.
The esul s o he analysis e ealed ha he e was a
signi ican associa ion be ween s uden s who FSP
pa icipa ed in imp o ing hei unde s anding o EMR
sys em in eg a ion and in e ope abili y (p < 0.001),
imp o ing compliance wi h EMR e hics and egula ions
(p < 0.001), abili y o de elop so skills in hei p ac ice
en i onmen (p < 0.001), and abili y o analyze and make
decisions based on EMR da a (p < 0.001) (Table 2).
Based on he esul s o he bina y logis ic eg ession
analysis (Table 3), he e is a signi ican associa ion
be ween s uden s who pa icipa e in he FSP and hei
unde s anding o he basic concep s and unc ions o
EMR (p = 0.001, AOR: 3.728). S uden s who
pa icipa ed in FSP a he hospi al had echnical skills in
using EMR 3.491 imes be e han s uden s who
pa icipa ed in FSP a CHCs. In addi ion, he e was a
signi ican associa ion be ween s uden s who a ended
FSP and echnical skills in he use o EMR (p = 0.001,
AOR: 3.491). S uden s who FSP pa icipa ed a he
hospi al had echnical skills in he use o EMR 3.491
imes be e han s uden s who FSP pa icipa ed a CHC.
[ DOI: 10.61186/edcj.18.1.87 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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Halid e al
.
: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 91
Table 2. The esul s o bi a ia e analysis o s uden s who pa icipa ed in FSP
Va iables
Following FSP
χ2
p
Hospi al
CHC
Unde s anding EMR basic concep s and unc ions n (%)
Unde s ood
117 (72.7)
44 (27.3)
45.968
< 0.001
Less unde s anding
29 (29.6)
69 (70.4)
Technical skills in EMR usage n (%)
Skilled
118 (76.1)
37 (23.9)
61.273
< 0.001
Less skilled
28 (26.9)
76 (73.1)
Unde s anding da a secu i y and p i acy n (%)
Unde s ood
101 (74.3)
35 (25.7)
37.284
< 0.001
Less unde s anding
45 (36.6)
78 (63.4)
Unde s anding o EMR wo k low and usage p ocedu es n (%)
Unde s ood
113 (70.2)
48 (29.8)
33.023
< 0.001
Less unde s anding
33 (33.7)
65 (66.3)
Unde s anding o EMR sys em in eg a ion and in e ope abili y n (%)
Unde s ood
96 (80.7)
23 (19.3)
52.864
< 0.001
Less unde s anding
50 (35.7)
90 (64.3)
Compliance wi h EMR e hics and egula ions n (%)
Unde s ood
91 (74.6)
31 (25.4)
31.130
< 0.001
Less unde s anding
55 (40.1)
82 (59.9)
Abili y o de elop so skills in a p ac ice en i onmen n (%)
Capable
100 (76.3)
31 (23.7)
42.961
< 0.001
Incapable
46 (35.9)
82 (64.1)
Abili y o analyze and make decisions based on EMR da a n (%)
Capable
90 (70.9)
37 (29.1)
21.289
< 0.001
Incapable
56 (42.4)
76 (57.6)
No e: Chi-squa e es was employed o compa e pa icipan s.
Abb e ia ions: FSP, ield s udy p ac ice; CHC, communi y heal h cen e ; χ2, Chi-squa e es ; p, p- alue.
The e was a signi ican associa ion be ween s uden s
who FSP pa icipa ed and he le el o unde s anding o
da a secu i y and p i acy (p = 0.002, AOR: 3.221).
S uden s who pa icipa ed in FSP a he hospi al had a
be e unde s anding o da a secu i y and p i acy, 3.491
imes highe han s uden s who pa icipa ed in FSP a
CHCs. In addi ion, he e was a signi ican associa ion
be ween s uden s who ake FSP and he le el o
unde s anding o wo k low and p ocedu es o using
EMR (p = 0.041, AOR: 2.191). S uden s who FSP
pa icipa ed a he hospi al had a le el o unde s anding
o he wo k low and p ocedu es o using EMR 2.191
imes be e han s uden s who FSP pa icipa ed a CHC
(Table 3). The esul s o he s udy showed ha he e was
a signi ican associa ion be ween s uden s who a ended
FSP and unde s anding o EMR sys em in eg a ion and
in e ope abili y (p = 0.008, AOR: 2.765). Thus, S uden s
who pa icipa ed in FSP a he hospi al had a be e
unde s anding o EMR sys em in eg a ion and
in e ope abili y, 2.765 imes highe han hose a CHCs.
In addi ion, he e was a signi ican associa ion be ween
s uden s who a ended FSP and compliance wi h EMR
e hics and egula ions (p = 0.001, AOR: 3.370). S uden s
who FSP pa icipa ed a he hospi al had compliance wi h
EMR e hics and egula ions 3.370 765 imes be e han
s uden s who FSP pa icipa ed a CHC (Table 3). The e
was a signi ican associa ion be ween s uden s who
a ended FSP and he abili y o de elop so skills in a
p ac ical en i onmen (p = 0.018, AOR: 2.397). This
indica es ha s uden s who ake FSP a he hospi al ha e
he abili y o de elop so skills in he p ac ical
en i onmen 2.397 imes be e han s uden s who ake
FSP a CHC. In addi ion, he e was a signi ican
associa ion be ween s uden s who a ended he FSP and
he abili y o analyze and make decisions based on EMR
da a (p = 0.025, AOR: 2.294). Thus, s uden s who FSP
pa icipa ed a he hospi al ha e he abili y o analyze and
make decisions based on EMR da a 2.294 imes be e
han s uden s who FSP pa icipa ed a CHC (Table 3).
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: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
92 Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1 ¦ 2025
Table 3. Resul s o mul i a ia e analysis o s uden s who pa icipa ed in FSP
Va iables
AOR
95%CI
p
Unde s anding o EMR basic concep s and unc ions ( e : Unde s ood)
Less unde s anding
3.728
1.694 - 8.203
0.001
Technical skills in EMR usage ( e : Skilled)
Less skilled
3.491
1.622 - 7.516
0.001
Unde s anding o da a secu i y and p i acy ( e : Unde s ood)
Less unde s anding
3.221
1.561 - 6.647
0.002
Unde s anding o EMR wo k low and usage p ocedu es ( e : Unde s ood)
Less unde s anding
2.191
1.032 - 4.651
0.041
Unde s anding o EMR sys em in eg a ion and in e ope abili y ( e : Unde s ood)
Less unde s anding
2.765
1.311 - 5.832
0.008
Compliance wi h EMR e hics and egula ions ( e : Unde s ood)
Less unde s anding
3.370
1.636 - 6.942
0.001
Abili y o de elop so skills in a p ac ice en i onmen ( e : Capable)
Incapable
2.397
1.165 - 4.929
0.018
Abili y o analyze and make decisions based on EMR da a ( e : Capable)
Incapable
2.294
1.111 - 4.737
0.025
No e: Bina y eg ession logis ic es was used o compa e pa icipan s; AOR has been used o measu e he dep h o associa ion be ween a iables.
Abb e ia ions: AOR, adjus ed odds a io; 95%CI, 95% con idence in e al; p, p- alue.
Discussion
FSP allows s uden s o apply class oom heo ies o eal-
li e si ua ions, p o iding hands-on expe ience wi h EMR
sys ems in HCF [20, 21]. This helps hem unde s and no
only how EMR wo ks, bu also he impo ance o he
sys em in imp o ing e iciency and accu acy in pa ien
da a managemen . EMR has se e al basic unc ions,
including he collec ion, s o age, and managemen o
pa ien heal h in o ma ion [22]. P e ious s udies
conduc ed in Saudi A abia ha e e ealed ha by
unde s anding hese basic concep s and unc ions,
s uden s a e be e equipped o con ibu e o a mode n
heal hca e sys em [23]. In he ield p ac ice, s uden s can
see i s -hand how pa ien da a is inpu ed, accessed, and
managed, as well as he ole o EMR in imp o ing
coo dina ion be ween heal h p o essionals [24].
In addi ion o imp o ing concep unde s anding, FSP
also con ibu es o he de elopmen o s uden s' p ac ical
skills [25]. In a eal-wo ld en i onmen , s uden s can
lea n o use EMR so wa e and adap o a ious
si ua ions ha may be encoun e ed in he ield [26].
These skills a e essen ial, especially when i comes o
wo king wi h medical eams and communica ing wi h
pa ien s abou heal h in o ma ion [27]. Ano he s udy
conduc ed in Saudi A abia e ealed ha FSP encou ages
s uden s o de elop in e pe sonal, communica ion, and
p oblem-sol ing skills ha a e c ucial in heal hca e
p ac ice [12]. In p ac ice, s uden s who ha e pa icipa ed
in FSP show signi ican imp o emen s in hei echnical
skills compa ed o hose who ha e only lea ned heo y in
he class oom [8]. S uden s unde s and a ious aspec s o
secu i y, including da a enc yp ion, access con ol, and
p i acy policies. Wi h his knowledge, hey can
con ibu e o c ea ing mo e secu e and e ec i e sys ems
[28]. A p e ious s udy conduc ed by Repsha e al.
e ealed ha h ough FSP, s uden s a e able o obse e
how o he heal hca e p o essionals ca e ully manage
pa ien da a, and a e awa e o he p o ocols ollowed o
p o ec ha in o ma ion [5]. The expe ience ein o ces
he heo e ical unde s anding hey ha e lea ned in class,
so ha hey can be e app ecia e he impo ance o da a
secu i y and p i acy [29]. EMRs a e equipped wi h
a ious ad anced ea u es, such as au oma ic eminde s
o ou ine check-ups o in eg a ion wi h labo a o y
sys ems [30]. The expe ience builds hei abili y o wo k
as pa o a la ge heal hca e eam [31]. Imp o ed s uden
unde s anding o EMR wo k lows and p ocedu es
h ough FSP also has a posi i e impac on he quali y o
heal h se ices [32]. Ano he s udy conduc ed in
Aus alia e ealed ha s uden s who ha e a good
unde s anding o EMR can p o ide e icien and accu a e
se ices o pa ien s [6]. Such unde s anding can educe
e o s in pa ien da a managemen and imp o e o e all
pa ien sa e y [5]. In addi ion, s uden s ained in EMR
use may become agen s o change in he u u e, d i ing
u he echnology adop ion wi hin heal hca e
o ganiza ions [20]. Th ough he FSP, s uden s ha e he
oppo uni y o be in ol ed in p ojec s ela ed o he
de elopmen and main enance o EMR sys ems. This
may include aining in he use o so wa e, da a analysis,
as well as he de elopmen o S anda d Ope a ional
P ocedu es (SOPs) o ensu e p ope in eg a ion be ween
sys ems [4]. This p ac ical expe ience also assis s
s uden s in unde s anding he complexi ies associa ed
wi h sys em in eg a ion [26]. They lea n how di e en
sys ems unc ion, he challenges ha a ise when hey
ha e o communica e wi h each o he , and he
impo ance o accu a e and consis en da a [1]. S uden s
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Halid e al
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: The ole o ield s udying p ac ices in imp o ing unde s anding and skills o using elec onic medical
eco ds among medical eco ds and heal h in o ma ion s uden s
Jou nal o Medical Educa ion De elopmen ¦ Volume 18 ¦ Issue 1¦ 2025 93
in ol ed in FSP need o unde s and he basic p inciples
o medical e hics, such as au onomy, jus ice, and
bene icence, as well as he egula ions go e ning he use
o EMR [12]. P e ious s udies conduc ed in Saudi
A abia e ealed ha s uden s who do well in FSP end o
ha e highe le els o compliance wi h EMR e hics and
egula ions [30]. S uden s in ol ed in he FSP gained a
be e unde s anding o he consequences o e hical
iola ions, especially in he con ex o pa ien da a
managemen [22]. Th ough i s -hand expe ience, hey
can see how such iola ions can impac pa ien s and
heal hca e p o essionals [9]. Compliance wi h elec onic
medical eco d e hics and egula ions is a e y impo an
aspec o heal hca e educa ion. FSPs play a c ucial ole
in shaping s uden s' a i udes and beha io s owa ds
EMR managemen [25]. So skills co e a wide ange o
in e pe sonal and in ape sonal abili ies, such as
communica ion, eamwo k, leade ship, empa hy, and
p oblem-sol ing skills. In heal hca e, so skills a e
pa icula ly impo an because heal hca e p o essions
ocus no only on he medical aspec s bu also on
in e ac ions wi h pa ien s, hei amilies, and cowo ke s
[7]. Ano he s udy explains ha FSPs gi e s uden s he
oppo uni y o lea n abou medical p ocedu es and
pa ien ca e, bu also how o communica e wi h pa ien s,
handle s ess ul si ua ions, and wo k wi h
mul idisciplina y eams [5]. The expe ience helps
s uden s o de elop empa hy and e ec i e
communica ion skills [21].
Conclusion
The ole o FSP as a hands-on lea ning me hod has a
posi i e impac on s uden s' unde s anding and skills in
EMR sys em managemen . S uden s who ge quali y
p ac ical expe ience ha e a be e unde s anding han
hose who only ecei e heo e ical lea ning. By
maximizing he quali y o FSP, educa ional ins i u ions
can be e p epa e g adua es o ace challenges in he e a
o heal hca e digi aliza ion. The s udy indings ha e
signi ican implica ions o he u u e in ha he FSP
me hod is e ec i e o imp o ing s uden s'
unde s anding and skills. The indings encou age
s onge in eg a ion be ween heo y and p ac ice in
MRHI educa ion cu iculum de elopmen . Educa ional
ins i u ions can inc ease he ocus on EMR aining
be o e and du ing FSP o ensu e s uden s a e p epa ed o
wo k demands. S udies on he de elopmen o FSP
guidelines need o be conduc ed so ha he compe encies
achie ed a e mo e comp ehensi e. Fu u e esea ch on
he ole o FSP in EMR mas e y can make an impo an
con ibu ion o he de elopmen o highe educa ion in
heal hca e. Unde s anding he ac o s ha in luence he
success o FSP allows educa ional ins i u ions o c ea e
mo e ele an and inno a i e lea ning s a egies. This, in
u n, equips s uden s o ackle he challenges posed by
digi al ans o ma ion in he heal h sec o .
E hical conside a ions
The s udy was conduc ed ollowing he e hics commi ee
p ocess and has ecei ed app o al om he E hics
Commi ee o Heal h Resea ch (ECHR) a he Ins i u e
o Resea ch and Communi y Se ice, Poli eknik Medica
Fa ma Husada Ma a am. The app o al is documen ed
unde Numbe : 13/LPPM/ECHR/2024.
A i icial in elligence u iliza ion o a icle
w i ing
Using G amma ly o punc ua ion and g amma
co ec ion in manusc ip .
Acknowledgmen
The au ho s would like o hank Poli eknik Medica
Fa ma Husada Ma a am and he s uden s who
pa icipa ed in his s udy.
Con lic o in e es s a emen
All au ho s decla e ha he e is no con lic o in e es .
Au ho con ibu ions
Muspa lin Halid, and Beny Bina o Budi Susilo: s udy
design, da a collec ion, da a analysis, and in e p e a ion.
All au ho s o he s udy con ibu ed h oughou app o ed
he inal o he manusc ip .
Funding
The s udy has no been unded by any o ganiza ion o
ins i u ion.
Da a a ailabili y s a emen
S udy da a a ailable upon eade eques .
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[ DOI: 10.61186/edcj.18.1.87 ] [ Downloaded om edujou nal.zums.ac.i on 2025-10-03 ]
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