TABLE 2.

Properties of the Learning Electronic Health Record

Property or Process	Existing EHR	Learning EHR
Data collection	Business analytics	Business analytics
	Clinical analytics	Clinical analytics
		… And learning analytics
Boundaries	QI-PS distinct from education	Education-QI-PS integrated
Learning IT architecture	EHR and LMS are distinct	Integrate LMS with EHR; recognizes common mission
Educational philosophy	Cognitivism—one right objective truth	Constructivism—health care complexity and individuality taken into account
Instructional design	Instructor	Coach
		Mentor; team
Target educational unit	Average brain	Individual brain
		Team/collective competence
EHR memory	Each learner interaction with EHR forgotten.	Accumulated personal experience reflected in longitudinal learning views
Communication mode	Pushing from organization	Listening by EHR;
		Dialogue with organization
Feedback	Scarce	Abundant
	Decontextualized	Contextualized

EHR indicates electronic health record; LMS, learning management system; PS, patient safety; QI, quality improvement.