In an attempt to prepare new graduate nurses to meet the demands of health care delivery systems, the use of computer-based clinical information systems that combine hands-on experience with computer based information systems was explored. Since the introduction of Electronic Medical Records (EMR) nearly two decades ago, the demand for nurses to be efficient in using computerized-based tools to deliver safe, efficient, quality care to patients is higher than ever. The academic EMR is an academic tool that enables nursing students to develop competence in health care decision-making using computerized information systems in a simulated environment (Maki, 2004). The purpose is to combine core nursing competencies with technology in various classroom settings and homework assignments in order to create a realistic clinical picture that improves critical thinking skills. This study used a quasi-experimental pretest/posttest design to compare critical thinking skill before and after participating in an academic EMR case study. Subjects included in this study included 24 first semester nursing mobility students enrolled in an associate degree nursing program. Data were obtained from the Health Science Reasonings Test (HSRT). A paired t-test and Pearson r correlation coefficient were used to assess differences in the pretest and posttest results of the subjects' total score and identified in the HSRT. The results of the study demonstrated a statistically significant difference in pretest and posttest scores, indicating that the academic EMR has an impact on critical thinking in nursing students. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]