Within the past decade, the introduction of computerized medical records into the business and practice of health care has created a need for effective training. The implementation of computerized medical records into a health care organization has been often associated with increased costs and decreased productivity. Although existing human performance technology literature has explored the impact of the organizational environment on training design and delivery in non-healthcare settings, little was known of the barriers, enablers, or organizational environmental factors that were encountered by informatics nurses as they designed and delivered computerized clinical documentation training in a healthcare setting. This mixed methods study surveyed board certified informatics nurses and nursing executives involved in computerized clinical documentation training in order to explore the training design and delivery process. Barriers to training previously documented in non-health care organizations were found to align with training barriers found in health care organizations that emerged in the research data, and additional barriers unique to training within a health care environment were identified. Results of this initial research study may provide a greater understanding of the barriers and enablers associated with the development and delivery of computerized clinical documentation training and the impact of the health care organizational environment on the training process so that the training process can be enhanced. [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/en-US/products/dissertations/individuals.shtml.]