STEP-UP with Nurses: Impact of a Peer-Led Post-Implementation EHR Educational Series (STEP-UP)
Technology
Training ＆ Education
Singapore Health Biomedical Congress
National Healthcare Group
14 January 2026
Peer-led teaching, which leverages shared clinical experience and cognitive congruence, was hypothesized to improve nurses'. STEP-UP demonstrates that continuous peer-led training can significantly improve perceived EPIC efficiency and user acceptance.
Year Submitted: 2025
Published Date: 14 January 2026
Tags: Digitalisation, Technology, Learning Approach, Learning Culture, Training ＆ Education
About this Content
Aims
Peer-led teaching, which leverages shared clinical experience and cognitive congruence, was hypothesized to improve nurses' EHR acceptance and efficiency.
Background
Pre-implementation strategies are often deemed essential for a smooth Electronic Health Records (EHRs) transitions. However, the post-implementation phase is often overlooked despite its crucial role in sustaining adoption and optimising efficiency.
Methods
STEP-UP (System Training for EPIC Proficiency - Unleashing its Potential), a peer-led educational program, was implemented at Tan Tock Seng Hospital from January to April 2025. The program comprised three components: hospital-wide virtual sessions, unit-based discussions, and hands-on practice. Using convenience sampling, 528 participants were surveyed using the Unified Theory of Acceptance and Use of Technology (UTAUT), which evaluates five domains: performance expectancy, effort expectancy, social influence, facilitating conditions, and behavioral intention. One-way ANOVA and post-hoc test compared differences across session attendance, while system-generated EPIC utilization data evaluated documentation efficiency.
Results
Participants who completed all three sessions demonstrated significantly higher UTAUT scores than single-session attendees (MD=0.170.24, p 0.05) across overall UTUAT and all subdomains except performance expectancy. System utilization showed marked improvement, with Smartlink usage increasing from baseline (1155) to post-intervention (3288, +184.7%). The 4-month average EPIC active time per user per patient per day decreased from 9.29 minutes (September to December 2024) to 8.15 minutes (January to April 2025), representing a 12.3% improvement in documentation efficiency.
Conclusion
STEP-UP demonstrates that continuous peer-led training can significantly improve perceived EPIC efficiency and user acceptance. It presents a scalable model for sustaining EHR proficiency postimplementation and bridging nursing digital literacy gap implementation and bridging nursing digital literacy gaps.
Lessons Learnt
We learnt that sustainability in knowledge sharing comes from empowering colleagues, not relying solely on central trainers. This approach challenged traditional models and highlighted the value of collaboration in overcoming resource limitations. We also realized that fostering a culture of continuous digital learning is not just about technologyits about mindset. Encouraging curiosity and adaptability among nurses ensures long-term engagement with health innovations. High participant satisfaction reminded us that when learners feel supported and see relevance, digital learning becomes a catalyst for transformation. STEP-UP demonstrated that scalable models can drive both education and enthusiasm for health technology.
Keywords
Nursing, Efficiency, Productivity, NGEMR, EPIC Hyperspace
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | Singapore Health Biomedical Congress |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Healthcare Administrators |
Project Lead(s) | Aletheia Lai XuanYu, Nguyen Phuong Thanh |
Project Member(s) | Neo Yi Ling |
Connect with this contributor!
Aletheia - aletheia.xuanyu.lai@nhghealth.com.sg