## 4 Results
### Brokering  
By brokering, we reference statements from residents that relayed the importance of their presence and expertise to mediate between the EHR screen and patients. The rationale has roots in physician concerns that patients will have \"unfettered access\" to their paper record [48], which predate the EHR and the initiation of medical training for these residents. Nonetheless, residents had access to the script and applied it to justify their behaviors. For instance, a female third-year resident describing how she decides whether to share the screen said, \"there's not that many occasions where I've necessarily felt that it was really necessary for their understanding.\" The resident believes she intervenes between the patient and the information in the EHR and situates her expertise as central for determining whether the two should interface.  
In instances where the screen was shared, residents continued to depict themselves as brokers by focusing on their role in distilling and interpreting information from the screen for patients. A male third-year resident relayed that \"the use of medical jargon in documentation may not be perceived in the appropriate manner by the patient,\" echoing concerns that once again predate the EHR [48]. The sentiment also reverberates with other qualitative and quantitative studies showing physicians are concerned that patients would not understand or would react with undue worry to notes [18; 64; 65], despite patients reporting otherwise [40; 64]. Thus, the rationale persists in new contexts despite lack of corroboration from the external environment [52; 53] and the direct experience with old ways of doctoring.  
Other residents focused on their role in sifting through the volume of information available on the screen for patients, as evidenced in the comments by a female second-year resident: \"You know, I don't wanna confuse them... especially 'cuz [it] can be pretty complex in parts... That's why I try to look at simple sources rather than just show them the whole screen.\" Although residents reported little training in how to use the EHR in the presence of patients, this resident is implicitly asserting that only she possesses the expertise to decipher the information for patients.  
Brokering also involved mediating the interpretation of results to avoid undue harm to patients. For example, a male first-year resident said:  
_\"If you have a particularly anxious patient, you know, every-every lab printout form, if it's just like a decimal point out of the standardized normal accepted reference range, then they-they might get a little anxious and freak out and need somebody to calm them down a little bit... it might be something that's kind of irrelevant, but, you know, since they don't have the understanding, they just see this as abnormal... but, I think, being right by with them as you're doing it,..., alleviates that.\"_  
Here, the resident is guided by a service-orientation to the patient, but still positions himself as an interpreter of the information on the screen as key because patients \"don't have the understanding,\" despite patients' ability to cultivate it through practice [40; 64].  
Altogether, the logic used to reason about screen sharing appeared to emphasize that residents are different from patients because they possess the skills necessary to interpret information on the screen. The presence of the EHR could risk compromising physicians' position as brokers between their clients and the domain of knowledge in which they claim expertise [63; 66]. Their comments align with boundary protection behaviors, despite not directly characterizing them as such. Instead, like in other studies of professionals, their boundary protection behaviors are implicit [50; 67]. The residents applied narratives predating the EHR that were historically applied to paper-based records, much like other professionals seeking to stabilize technological disruptions [38], except they did not have direct experience with the older technology.