The effective and efficient use of the electronic health record is an integral component of training for residents. Studies have shown that physicians that have a good understanding of the electronic record and are able to work efficiently suffer less burnout and are generally more satisfied in their daily work life. Efficiency training is necessary to become a more proficient user of the electronic record. Proficiency is related to the use of available tools and structure where efficiency is more a measure of ability to accomplish work within the system. Both concepts carry equal weight in how well a physician uses a structured system. The goal of this elective is to help provide a basis for building practices that breed efficiency in documentation and system utilization.