Listening to the note: clinician perspectives on ambient artificial intelligence scribes in medical documentation

Jen Van Tiem; Elizabeth Cramer; Christopher Iverson; Korey Kennelty; Noah Andrys; Julie Lee; Lindsey Knake; Jason Misurac; James Blum; Heather Schacht Reisinger

doi:10.1093/jamia/ocaf214

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Listening to the note: clinician perspectives on ambient artificial intelligence scribes in medical documentation

Journal article

Open access

Peer reviewed

Listening to the note: clinician perspectives on ambient artificial intelligence scribes in medical documentation

Jen Van Tiem, Elizabeth Cramer, Christopher Iverson, Korey Kennelty, Noah Andrys, Julie Lee, Lindsey Knake, Jason Misurac, James Blum and Heather Schacht Reisinger

Journal of the American Medical Informatics Association : JAMIA, Vol.33(2), pp.255-262

02/01/2026

DOI: 10.1093/jamia/ocaf214

PMCID: PMC12844589

PMID: 41340524

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Abstract

To qualitatively characterize barriers and facilitators to implementing and using an ambient scribe across a large academic medical center, as well as how ambient transcription reshapes clinicians' perceptions of their work. We conducted semistructured interviews with clinicians who participated in an ambient scribe pilot (n = 8) and the initial enterprise rollout (n = 16). We sought heterogeneity by specialty, note volume, burnout, and prior time-in-notes. Interviews (26-60 min) were recorded, transcribed, and analyzed thematically using a naturalistic, ethnographic approach informed by broad implementation considerations, and an analytic lens treating note sections as documentation "genres." Clinicians described feeling more present with patients and greater satisfaction during visits. Fictions included overlong or underspecified sections (eg, History of Present Illness vs Assessment & Plan), unfamiliar formatting, and a perceived loss of "voice." Participants discussed how they used documentation to personalize practice, demonstrate expertise, manage impressions with colleagues and supervisors, and communicate sensitive findings-activities not fully captured by efficiency metrics. Inpatient and procedure-heavy contexts reported limited benefit where documentation was already highly standardized. Early ambient scribe implementation produced recognizable benefits, but introduced new work to reconcile AI-drafted text with local documentation genres and audience-specific communication. Tailored prompts, onboarding, and peer support may reduce the need to revise artificial intelligence (AI)-generated text. Ambient scribe adoption can enhance patient interactions and perceived efficiency while reshaping how clinicians express voice and expertise in notes. Implementation strategies attentive to documentation genre and audience may help align ambient scribe outputs with clinical communication needs.

evaluation

qualitative

implementation

ambient scribe

generative artificial intelligence

UIOWA OA Agreement

Details

Title: Subtitle: Listening to the note: clinician perspectives on ambient artificial intelligence scribes in medical documentation
Creators: Jen Van Tiem - Implementation Science Center, University of Iowa, Iowa City, IA 52242, United States
Elizabeth Cramer - University of Iowa
Christopher Iverson - University of Iowa
Korey Kennelty - University of Iowa
Noah Andrys - Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States
Julie Lee - University of Iowa
Lindsey Knake - University of Iowa
Jason Misurac - University of Iowa, Nephrology, Dialysis and Transplantation
James Blum - University of Iowa
Heather Schacht Reisinger - University of Iowa
Resource Type: Journal article
Publication Details: Journal of the American Medical Informatics Association : JAMIA, Vol.33(2), pp.255-262
DOI: 10.1093/jamia/ocaf214
PMID: 41340524
PMCID: PMC12844589
NLM abbreviation: J Am Med Inform Assoc
ISSN: 1067-5027
eISSN: 1527-974X
Publisher: Oxford University Press
Grant note: Department Executive Officer of Family and Community Medicine at the University of Iowa Carver College of Medicine
Language: English
Electronic publication date: 12/03/2025
Date published: 02/01/2026
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Occupational and Environmental Health; Nephrology, Dialysis and Transplantation; Health Management and Policy; Stead Family Department of Pediatrics; Family and Community Medicine; Pharmacy Practice and Science; Center for Social Science Innovation; Anesthesia; Injury Prevention Research Center; Neonatology; Internal Medicine
Record Identifier: 9985090731102771

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