Development and Implementation of an Oral Sign-out Skills Curriculum
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Imperfect sign-out of patient information between providers has been shown to contribute to medical error, but there are no standardized curricula to teach sign-out skills. At our institution, we identified several deficiencies in skills and a lack of any existing training.
To develop a sign-out curriculum for medical house staff. Setting: Internal medicine residency program.
We developed a 1-h curriculum and implemented it in August of 2006 at three hospital sites. Teaching strategies included facilitated discussion, modeling, and observed individual practice with feedback. We emphasized interactive communication, a structured sign-out format summarized by an easy-to-remember mnemonic (“SIGNOUT”), consistent inclusion of key content items such as anticipatory guidance, and use of concrete language.
We received 34 evaluations. The mean score for the course was 4.44 ± 0.61 on a 1–5 scale. Perceived usefulness of the structured oral communication format was 4.46 ± 0.78. Participants rated their comfort with providing oral sign-out significantly higher after the session than before (3.27 ± 1.0 before vs. 3.94 ± 0.90 after; p < .001).
We developed an oral sign-out curriculum that was brief, structured, and well received by participants. Further study is necessary to determine the long-term impact of the curriculum.