Journal of General Internal Medicine

, Volume 25, Issue 2, pp 129–134

Hand-off Education and Evaluation: Piloting the Observed Simulated Hand-off Experience (OSHE)

Authors

    • Section of Hospital Medicine, Department of MedicineThe University of Chicago
  • J. A. M. Paro
    • The University of Chicago, Pritzker School of Medicine
  • R. M. Rodriguez
    • The University of Chicago, Pritzker School of Medicine
  • S. T. Reddy
    • Section of Hospital Medicine, Department of MedicineThe University of Chicago
    • The University of Chicago, Pritzker School of Medicine
  • L. I. Horwitz
    • Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven CT; Section of General Internal Medicine, Department of MedicineYale University School of Medicine
  • J. K. Johnson
    • Centre for Clinical Governance Research, Faculty of MedicineUniversity of New South Wales
  • V. M. Arora
    • Section of General Internal Medicine, Department of MedicineThe University of Chicago
    • The University of Chicago, Pritzker School of Medicine
Innovations in Education

DOI: 10.1007/s11606-009-1170-y

Cite this article as:
Farnan, J.M., Paro, J.A.M., Rodriguez, R.M. et al. J GEN INTERN MED (2010) 25: 129. doi:10.1007/s11606-009-1170-y

Abstract

Aim

The Observed Simulated Hand-off Experience (OSHE) was created to evaluate medical students’ sign-out skills using a real-time assessment tool, the Hand-off CEX.

Setting

Thirty-two 4th year medical students participated as part of an elective course.

Program description

One week following an interactive workshop where students learned effective hand-off strategies, students participated in an experience in which they performed a hand-off of a mock patient using simulated history and physical examination data and a brief video.

Program evaluation

Internal medicine residents served as standardized hand-off receivers and were trained on expectations. Students were provided feedback using a newly developed Hand-off CEX, based on the “Mini-CEX,” which rates overall hand-off performance and its components on a 9-point Likert-type scale. Outcomes included performance ratings and pre- and post-student self-assessments of hand-off preparedness. Data were analyzed using Wilcoxon signed-rank tests and descriptive statistics. Resident receivers rated overall student performance with a mean score of 6.75 (range 4–9, maximum 9). Statistically significant improvement was observed in self-perceived preparedness for performing an effective hand-off (67% post- vs. 27% pre-reporting ‘well-prepared,’ p < 0.009).

Discussion

This brief, standardized hand-off training exercise improved students’ confidence and was rated highly by trained observers. Future work focuses on formal validation of the Hand-off CEX instrument.

Key Words

hand-offssimulationresidency education

Supplementary material

11606_2009_1170_MOESM1_ESM.pdf (800 kb)
Appendix AOSHE student education teaching slides (PDF 799 kb)
11606_2009_1170_MOESM2_ESM.pdf (31 kb)
Appendix BStandardized Hand-off mock chart (PDF 30.7 kb)
11606_2009_1170_MOESM3_ESM.pdf (21 kb)
Appendix COSHE training goals and objectives (PDF 21.3 kb)
11606_2009_1170_MOESM4_ESM.pdf (13 kb)
Appendix DStandardized written hand-off template (PDF 12.7 kb)
11606_2009_1170_MOESM5_ESM.pdf (867 kb)
Appendix EOSHE rater training slides (PDF 867 kb)

Copyright information

© Society of General Internal Medicine 2009