Residents' typing skills were categorized as follows: (1) fewer than 26 net WPM = very slow (2) 26 to 35 net WPM = slow (3) 35 to 45 net WPM = intermediate and (4) greater than 45 net WPM = fast. Gross WPM were calculated from these data, and net WPM were calculated by subtracting errors (net WPM = gross WPM − number of errors). Custom software that calculates typing speeds (Techforis Inc, Nashua, NH) was used for the online typing tests. The in-person typing portion of the assessment was recorded in seconds by a researcher using a stopwatch. Participating residents were given a typing test, either in person or online, with a paragraph containing 100 alphanumeric words of a patient history. Residents were asked to rate their typing skills as slow ( 45 WPM), and to indicate importance they assigned to typing for a resident (not important/somewhat important/very important). Participants were also asked when they learned to type (before high school/during high school/college/other) and whether they learned on a typewriter or a computer. We collected the following demographic data: specialty, postgraduate year (PGY)-1 to PGY-7, citizenship, and the country where participants attended medical school. All residents (N = 249) and fellows (N = 31) at NYMH were invited in person or via e-mail to voluntarily participate in the study.
