1 Health Information Management Research Center, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran

2 Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran Student Research Committee, Kashan University of Medical Sciences, Kashan, Iran

3 Trauma Research Center and Educational Development Center, School of Allied Medical Sciences Anaesthesia Department, Kashan University of Medical Sciences, Kashan, Iran


One of the most commonly used methods for training is simulation. It is important to examine the
effects of simulation training of health information systems on the knowledge, attitude, and skill in
trainees. This review provided a summary of relevant literature on how simulation training affects
the learning of health information systems and determine the features and functional capabilities
of existing simulators. Studies and websites using simulation training to teach health information
systems were included. Studies were searched through Medline (via PubMed), Scopus, and ISI Web
of Science and websites through Google search by the end of 2019. The characteristics of studies,
features, and functional capabilities of simulators and effects on learning outcomes were extracted.
The included studies and websites were categorized according to different characteristics including
simulation types, learning outcome categories, and the effects of simulation training on learning
outcomes. The learning outcomes were categorized into four groups: knowledge, attitude, skill, and
satisfaction. The effects of interventions on outcomes were categorized into statistically significant
positive, positive without statistical argument, no effect (not statistically significant), negative without
statistical argument, or statistically significant negative. Ten studies and eight websites that used
simulation training to teach health information systems (mainly electronic health record [EHR])
were included. EHR simulation was performed in 80% of the included studies and trainees in 70%
of studies were physicians and nurses. All studies were conducted in three developed countries. In
the included studies, four learning outcomes (i.e. skill, attitude, knowledge, and satisfaction) were
assessed. Ninety percent of the included studies assessed skill‑related outcomes, with more than half
mentioning significant improvement. Thirty percent of the included studies assessed outcomes‑related
knowledge and attitude, all of which reported the positive effects of simulation training. The simulators
offered a variety of functional capabilities, while all of which simulated the clinical data entry process.
In teaching health information systems, especially EHRs, simulation training enhances skill, attitude,
knowledge, and satisfaction of health‑care providers and students.


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