The Role of Interactive Videos in EMR Education: Pilot Study of a Novel Simulated EMR for Non-Teaching Hospital Institutions

Introduction: Medication administration is a high-risk clinical task requiring accurate interaction with digital systems such as electronic medical records (EMRs) and barcode medication administration. Simulation-based training is used to prepare learners for these workflows; however, how users visually process training content remains underexplored. This study evaluates visual attention patterns during EMR-based nursing simulation training using areas of interest (AOI) based eye-tracking. Methods : A total of 37 participants (15 clinicians, 22 non-clinicians) completed a six-part interactive EMR training video using SimEMR©. Eye-tracking data were collected using Sticky by Tobii to capture fixation count, return fixations, fixation duration, and AOI coverage. Training performance was measured using post-video multiple-choice responses and analyzed using independent-samples t-tests and variance tests. Results : Non-clinicians demonstrated significantly higher fixation counts (~19 vs ~12, p < 0.001) and more return fixations (~52 vs ~37, p < 0.001) compared to clinicians. Variability in revisit behavior was lower among clinicians (p = 0.03). Total viewing time (p = 0.230) and AOI coverage (~91% for both groups, p = 0.865) were similar. Training performance did not differ between groups (~88.9% vs ~87.6%, p = 0.798). Conclusion : Clinicians and non-clinicians achieved comparable training outcomes despite differences in visual attention patterns. Non-clinicians exhibited higher visual effort and reprocessing behavior, while clinicians demonstrated more efficient and consistent attention strategies. AOI-based metrics provide a direct method to evaluate how users process training content and can inform the design of more effective nursing simulation training systems.