{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T17:27:41Z","timestamp":1773422861796,"version":"3.50.1"},"reference-count":70,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objectives\u2003This article investigates the association between changes in electronic health record (EHR) use during the coronavirus disease 2019 (COVID-19) pandemic on the rate of burnout, stress, posttraumatic stress disorder (PTSD), depression, and anxiety among physician trainees (residents and fellows).<\/jats:p><jats:p>\n          Methods\u2003A total of 222 (of 1,375, 16.2%) physician trainees from an academic medical center responded to a Web-based survey. We compared the physician trainees who reported that their EHR use increased versus those whose EHR use stayed the same or decreased on outcomes related to depression, anxiety, stress, PTSD, and burnout using univariable and multivariable models. We examined whether self-reported exposure to COVID-19 patients moderated these relationships.<\/jats:p><jats:p>\n          Results\u2003Physician trainees who reported increased use of EHR had higher burnout (adjusted mean, 1.48 [95% confidence interval [CI] 1.24, 1.71] vs. 1.05 [95% CI 0.93, 1.17]; p\u2009=\u20090.001) and were more likely to exhibit symptoms of PTSD (adjusted mean\u2009=\u200915.09 [95% CI 9.12, 21.05] vs. 9.36 [95% CI 7.38, 11.28]; p\u2009=\u20090.035). Physician trainees reporting increased EHR use outside of work were more likely to experience depression (adjusted mean, 8.37 [95% CI 5.68, 11.05] vs. 5.50 [95% CI 4.28, 6.72]; p\u2009=\u20090.035). Among physician trainees with increased EHR use, those exposed to COVID-19 patients had significantly higher burnout (2.04, p\u2009&lt;\u20090.001) and depression scores (14.13, p\u2009=\u20090.003).<\/jats:p><jats:p>\n          Conclusion\u2003Increased EHR use was associated with higher burnout, depression, and PTSD outcomes among physician trainees. Although preliminary, these findings have implications for creating systemic changes to manage the wellness and well-being of trainees.<\/jats:p>","DOI":"10.1055\/s-0041-1731000","type":"journal-article","created":{"date-parts":[[2021,6,3]],"date-time":"2021-06-03T00:36:18Z","timestamp":1622680578000},"page":"507-517","source":"Crossref","is-referenced-by-count":14,"title":["Impact of Changes in EHR Use during COVID-19 on Physician Trainee Mental Health"],"prefix":"10.1055","volume":"12","author":[{"given":"Katherine J.","family":"Holzer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Sunny S.","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Charles W.","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Jaime","family":"Strickland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Bradley A.","family":"Evanoff","sequence":"additional","affiliation":[{"name":"Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Jennifer G.","family":"Duncan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, United States"}]},{"given":"Thomas","family":"Kannampallil","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri, United States"},{"name":"Institute for Informatics, Washington University School of Medicine, St. Louis, Missouri, United 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