{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:19:35Z","timestamp":1783480775404,"version":"3.55.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Syst"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Clinical documentation is essential for safe and effective patient care but places a substantial clerical burden on doctors, particularly those early in training. Ambient artificial intelligence (AI) systems, which passively capture clinical conversations and generate structured notes, have demonstrated promise in outpatient and primary care settings. However, their use in inpatient ward rounds remains largely unexplored. Semi-structured interviews were conducted with ten postgraduate year one doctors following participation in simulated orthopaedic ward rounds incorporating an ambient AI scribe (Heidi Health, Melbourne, Australia). The topic guide was informed by Normalisation Process Theory (NPT) to explore participants\u2019 understanding of AI-assisted documentation workflows, the work they anticipated would be required at individual, team, and system levels for implementation, and their appraisal of the potential benefits, risks, and practical challenges of future use. Data were analysed collaboratively by two researchers using reflexive thematic analysis with a hybrid inductive\u2013deductive approach. Seven themes were identified and mapped across the four NPT constructs. Coherence was reflected in participants\u2019 understanding of ambient AI as a way to reduce documentation burden, support patient-centred records, and improve accessibility. Cognitive participation was evident in their recognition that implementation would require individual engagement, including review and approval of AI-generated outputs. Collective action captured the practical work required to adapt ward round behaviours, redistribute documentation tasks, manage consent, and address infrastructure, access, and governance requirements. Reflexive monitoring was demonstrated through participants\u2019 appraisal of anticipated benefits, including potential for improved clinical engagement, multidisciplinary communication, and real-time capture of complex conversations, balanced against risks of clinical misrepresentation, cultural resistance, and privacy concerns. Through simulated exposure, participants made sense of ambient AI scribes as a potentially valuable addition to inpatient documentation workflows, anticipating effects on efficiency, communication, and patient-centred documentation. However, they also identified individual, team, and organisational work required for implementation, including workflow adaptation, consent processes, data privacy, access controls, infrastructure, and real-world appraisal in clinical settings.<\/jats:p>","DOI":"10.1007\/s10916-026-02437-7","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:06:59Z","timestamp":1783480019000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exploring the Potential of Ambient AI for Inpatient Documentation: A Qualitative Study with Junior Doctors"],"prefix":"10.1007","volume":"50","author":[{"given":"Aisling","family":"Bracken","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"Whelehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita Rose","family":"Babu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Merghani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eoin","family":"Sheehan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Feeley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2437_CR1","doi-asserted-by":"crossref","unstructured":"Bjerkan J, Valderaune V, Olsen RM. Patient Safety Through Nursing Documentation: Barriers Identified by Healthcare Professionals and Students. Frontiers in Computer Science. 2021;Volume 3\u20132021.","DOI":"10.3389\/fcomp.2021.624555"},{"issue":"8","key":"2437_CR2","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1001\/jama.297.8.831","volume":"297","author":"S Kripalani","year":"2007","unstructured":"Kripalani S, LeFevre F, Phillips CO, Williams MV, Basaviah P, Baker DW. Deficits in communication and information transfer between hospital-based and primary care physicians: implications for patient safety and continuity of care. JAMA. 2007;297(8):831\u201341.","journal-title":"JAMA"},{"issue":"1","key":"2437_CR3","doi-asserted-by":"publisher","first-page":"84","DOI":"10.3414\/ME0569","volume":"48","author":"E Ammenwerth","year":"2009","unstructured":"Ammenwerth E, Spotl HP. The time needed for clinical documentation versus direct patient care. A work-sampling analysis of physicians\u2019 activities. Methods Inf Med. 2009;48(1):84\u201391.","journal-title":"Methods Inf Med"},{"issue":"6","key":"2437_CR4","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1002\/jhm.790","volume":"5","author":"MD Tipping","year":"2010","unstructured":"Tipping MD, Forth VE, O\u2019Leary KJ, Malkenson DM, Magill DB, Englert K, et al. Where did the day go?>--a time-motion study of hospitalists. J Hosp Med. 2010;5(6):323\u20138.","journal-title":"J Hosp Med"},{"issue":"4","key":"2437_CR5","doi-asserted-by":"publisher","first-page":"320","DOI":"10.7861\/clinmedicine.16-4-320","volume":"16","author":"J Sabin","year":"2016","unstructured":"Sabin J, Khan W, Subbe CP, Franklin M, Abulela I, Khan A, et al. \u2018The time it takes\u2026\u2019 How doctors spend their time admitting a patient during the acute medical take. Clin Med (Lond). 2016;16(4):320\u20134.","journal-title":"Clin Med (Lond)"},{"key":"2437_CR6","doi-asserted-by":"publisher","first-page":"215013192311669","DOI":"10.1177\/21501319231166921","volume":"14","author":"J Budd","year":"2023","unstructured":"Budd J. Burnout Related to Electronic Health Record Use in Primary Care. J Prim Care Community Health. 2023;14:21501319231166921.","journal-title":"J Prim Care Community Health"},{"issue":"3","key":"2437_CR7","doi-asserted-by":"publisher","first-page":"100157","DOI":"10.1016\/j.fhj.2024.100157","volume":"11","author":"J Balloch","year":"2024","unstructured":"Balloch J, Sridharan S, Oldham G, Wray J, Gough P, Robinson R, et al. Use of an ambient artificial intelligence tool to improve quality of clinical documentation. Future Healthc J. 2024;11(3):100157.","journal-title":"Future Healthc J"},{"issue":"8","key":"2437_CR8","doi-asserted-by":"publisher","first-page":"e2528056","DOI":"10.1001\/jamanetworkopen.2025.28056","volume":"8","author":"JG You","year":"2025","unstructured":"You JG, Dbouk RH, Landman A, Ting DY, Dutta S, Wang JC, et al. Ambient Documentation Technology in Clinician Experience of Documentation Burden and Burnout. JAMA Netw Open. 2025;8(8):e2528056.","journal-title":"JAMA Netw Open"},{"issue":"5","key":"2437_CR9","doi-asserted-by":"publisher","first-page":"e258614","DOI":"10.1001\/jamanetworkopen.2025.8614","volume":"8","author":"CD Stults","year":"2025","unstructured":"Stults CD, Deng S, Martinez MC, Wilcox J, Szwerinski N, Chen KH, et al. Evaluation of an Ambient Artificial Intelligence Documentation Platform for Clinicians. JAMA Netw Open. 2025;8(5):e258614.","journal-title":"JAMA Netw Open"},{"key":"2437_CR10","doi-asserted-by":"crossref","unstructured":"Treloar EC, Ey JD, Herath M, Edwardes NPR, Edwards S, Bruening MH, et al. Optimizing ward rounds: systematic review and meta-analysis of interventions to enhance patient safety. Br J Surg. 2025;112(4).","DOI":"10.1093\/bjs\/znaf041"},{"key":"2437_CR11","doi-asserted-by":"crossref","unstructured":"Green G, Aframian A, Bernard J. Ward round documentation in a major trauma centre: can we improve patient safety? BMJ Qual Improv Rep. 2014;3(1).","DOI":"10.1136\/bmjquality.u206189.w2537"},{"issue":"1","key":"2437_CR12","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1177\/00187208211064707","volume":"66","author":"UVU Ismatullaev","year":"2024","unstructured":"Ismatullaev UVU, Kim SH. Review of the Factors Affecting Acceptance of AI-Infused Systems. Hum Factors. 2024;66(1):126\u201344.","journal-title":"Hum Factors"},{"issue":"2","key":"2437_CR13","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.surge.2025.10.008","volume":"24","author":"A Bracken","year":"2026","unstructured":"Bracken A, Babu AR, Whelehan S, Merghani K, Sheehan E, Feeley I. Ambient AI reduces documentation time and enhances quality in a simulated inpatient setting. Surgeon. 2026;24(2):119\u201325.","journal-title":"Surgeon"},{"issue":"3","key":"2437_CR14","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1007\/s11135-021-01182-y","volume":"56","author":"D Byrne","year":"2022","unstructured":"Byrne D. A worked example of Braun and Clarke\u2019s approach to reflexive thematic analysis. Quality & Quantity. 2022;56(3):1391\u2013412.","journal-title":"Quality & Quantity"},{"issue":"3","key":"2437_CR15","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1177\/0038038509103208","volume":"43","author":"C May","year":"2009","unstructured":"May C, Finch T. Implementing, Embedding, and Integrating Practices: An Outline of Normalization Process Theory. Sociology. 2009;43(3):535\u201354.","journal-title":"Sociology"},{"key":"2437_CR16","doi-asserted-by":"publisher","first-page":"e74428","DOI":"10.2196\/74428","volume":"27","author":"C Blease","year":"2025","unstructured":"Blease C, Garcia Sanchez C, Locher C, McMillan B, Gaab J, Torous J. Generative Artificial Intelligence in Primary Care: Qualitative Study of UK General Practitioners\u2019 Views. J Med Internet Res. 2025;27:e74428.","journal-title":"J Med Internet Res"},{"issue":"3","key":"2437_CR17","first-page":"e107-e8","volume":"5","author":"SB Patel","year":"2023","unstructured":"Patel SB, Lam K. ChatGPT: the future of discharge summaries? Lancet Digit Health. 2023;5(3):e107-e8.","journal-title":"Lancet Digit Health"},{"issue":"1","key":"2437_CR18","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1186\/1472-6963-14-346","volume":"14","author":"J Allen","year":"2014","unstructured":"Allen J, Hutchinson AM, Brown R, Livingston PM. Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review. BMC Health Services Research. 2014;14(1):346.","journal-title":"BMC Health Services Research"},{"key":"2437_CR19","doi-asserted-by":"crossref","unstructured":"Clough RAJ, Sparkes WA, Clough OT, Sykes JT, Steventon AT, King K. Transforming healthcare documentation: harnessing the potential of AI to generate discharge summaries. BJGP Open. 2024;8(1).","DOI":"10.3399\/BJGPO.2023.0116"},{"issue":"8","key":"2437_CR20","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1038\/s41433-025-03767-5","volume":"39","author":"S Satheakeerthy","year":"2025","unstructured":"Satheakeerthy S, Jesudason D, Pietris J, Bacchi S, Chan WO. LLM-assisted medical documentation: efficacy, errors, and ethical considerations in ophthalmology. Eye. 2025;39(8):1440\u20132.","journal-title":"Eye"},{"key":"2437_CR21","unstructured":"NHS. Guidance on the use of AI-enabled ambient scribing products in health and care settings. 24 April 2026;Version 2."},{"issue":"2","key":"2437_CR22","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1097\/SLA.0000000000000376","volume":"259","author":"PH Pucher","year":"2014","unstructured":"Pucher PH, Aggarwal R, Darzi A. Surgical ward round quality and impact on variable patient outcomes. Ann Surg. 2014;259(2):222\u20136.","journal-title":"Ann Surg"},{"issue":"7","key":"2437_CR23","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1177\/014107680109400702","volume":"94","author":"G Neale","year":"2001","unstructured":"Neale G, Woloshynowych M, Vincent C. Exploring the causes of adverse events in NHS hospital practice. J R Soc Med. 2001;94(7):322\u201330.","journal-title":"J R Soc Med"},{"issue":"1","key":"2437_CR24","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1007\/s44250-024-00163-w","volume":"3","author":"R Sinha","year":"2024","unstructured":"Sinha R. The role and impact of new technologies on healthcare systems. Discover Health Systems. 2024;3(1):96.","journal-title":"Discover Health Systems"},{"issue":"2","key":"2437_CR25","doi-asserted-by":"publisher","first-page":"e2460642-e","DOI":"10.1001\/jamanetworkopen.2024.60642","volume":"8","author":"IG Cohen","year":"2025","unstructured":"Cohen IG, Ritzman J, Cahill RF. Ambient Listening\u2014Legal and Ethical Issues. JAMA Network Open. 2025;8(2):e2460642-e.","journal-title":"JAMA Network Open"}],"container-title":["Journal of Medical Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-026-02437-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10916-026-02437-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-026-02437-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:07:17Z","timestamp":1783480037000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10916-026-02437-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,8]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["2437"],"URL":"https:\/\/doi.org\/10.1007\/s10916-026-02437-7","relation":{},"ISSN":["1573-689X"],"issn-type":[{"value":"1573-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,8]]},"assertion":[{"value":"2 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval was reviewed and granted by the institution\u2019s local Research and Ethics Committee (Reference No. 20251647-RDMLRREC). Written informed consent was obtained from all participants prior to participation.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human Ethics and Consent to Participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"111"}}