Challenges in procuring an electronic patient record system for use in preregistration nursing education

Preregistration nursing programmes are designed to prepare students for the future nursing workforce and include a minimum of 2300 hours of clinical practice, up to 600 hours of which can be delivered through simulated practice learning (SPL) (Nursing and Midwifery Council (NMC), 2024). SPL is an education method where students can practise and achieve learning outcomes that they may not have the opportunity to achieve in practice (NMC, 2024).
This lack of opportunity can be due to reasons such as the student's allocated placement specialty not aligning with their learning outcomes, or the clinical area lacking capacity for supporting students based on staff availability.
However, the literature reports a theory-practice gap between what is taught at higher education institutions (HEIs) and what is observed in clinical practice, with theoretical content not aligning with the realities of clinical practice (Greenway et al, 2019; Mollart et al, 2023). The gap can be particularly noticeable within SPL (Thomas et al, 2024).
An electronic health record, also known as an electronic patient record (EPR), uses digital software for health professionals to document all aspects of patient care. It was expected that 95% of NHS trusts in England would be using an EPR system by March 2026, with the remaining 5% implementing plans to follow (NHS England, 2026). It is within the NHS where most UK nursing students have their clinical placements, and therefore they would have been exposed to patient documentation through this medium.
The unpublished Phillips Ives Review into nursing and midwifery digital readiness reportedly said that current models of nursing education do not prepare the future workforce for digitally enabled practice (Devereux, 2024). There is support in the literature for the argument that student exposure to EPR systems in preregistration education prepares them for clinical practice and increases their digital skills and confidence (Mollart et al, 2023; Irwin et al, 2024; Thomas et al, 2024).