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Does Medical Student Hand-Over Training on a Third-Year Pediatric Clerkship Improves Skill and Confidence Level?

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Abstract

Purpose

Patient hand-over is a critical skill to develop in the era of reduced duty hours. There is insufficient data in the literature that medical students, especially in the third year, are being instructed to participate in a patient hand-over. Early introduction into the curriculum should provide earlier competency which has the potential to decrease the number of medical errors related to communication.

Methods

All students were expected to use our institution’s hand-over mnemonic SAFETIPS when signing out on inpatient wards. Students were randomly assigned to a curriculum or control group and completed patient hand-over student confidence pre-surveys. The curriculum group participated in a faculty-led workshop at the beginning of the clerkship teaching hand-overs. Faculty members assessed student hand-overs at the end of clerkship, followed by a student post-survey.

Results

The statistically significant difference (P = .001) in median inventory scores (alpha = .70) for students in the curriculum (13.0(±2.0)) vs. control (12.0(±5.0)) is coupled to an effect size (Cliff’s d = 0.34). Five SAFETIPS items reported significant increases (p ≤ .050) for students in the curriculum vs. control. Significant increases in pre-/post-survey (alpha = .84/.87) scores are reported for students in the curriculum (pre/post difference = 9.0, P = .001) and in the control group (difference = 7.3, P = .001) for the survey. The largest individual item increases for both groups were “using SAFETIPS to give/listen to hand-over of patients” (difference = 2.0, P = .001).

Conclusions

Third-year medical student skill and confidence level giving patient hand-over using SAFETIPS is improved with the use of a formal curriculum.

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References

  1. Accreditation Council for Graduate Medical Education. Report of the work group on resident duty hours. http://www.ttuhsc.edu/sop/residencies/documents/ACGME_work_hour_policy.pdf. Accessed December 10, 2014.

  2. Steinbrook R. The debate over residents’ work hours. N Engl J Med. 2002;347:1296–302.

    Article  Google Scholar 

  3. Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, et al. Effect of reducing interns’ work hours on serious medical errors in intensive care units. N Engl J Med. 2004;351:1838–48.

    Article  Google Scholar 

  4. Lockley SW, Cronin JW, Evans EE, Cade BE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA. Effect of reducing interns’ weekly work hours on sleep and attentional failures. N Engl J Med. 2004;351:1829–37.

    Article  Google Scholar 

  5. Philibert I, Friedmann P, Williams WT. New requirements for resident duty hours. JAMA. 2002;288:1112–4.

    Article  Google Scholar 

  6. Horwitz LI, Krumholz HM, Green ML, Huot SJ. Transfers of patient care between house staff on internal medicine wards: a national survey. Arch Intern Med. 2006;166:1173–7.

    Article  Google Scholar 

  7. Vidyarthi AR, Arora V, Schnipper JL, Wall SD, Wachter RM. Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-out. J Hosp Med. 2006;1:257–66.

    Article  Google Scholar 

  8. Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. What are covering doctors told about their patients? Analysis of sign-out among internal medicine house staff. Qual Saf Health Care. 2009;18:248–55.

    Article  Google Scholar 

  9. Van Eaton EG, Tarpley JL, Solorzano CC, Cho CS, Weber SM, Termuhlen PM. Resident education in 2011: three key challenges on the road ahead. Surgery. 2011;149:465–73.

    Article  Google Scholar 

  10. Petersen LA, Brennan TA, O’Neil AC, Cook EF, Lee TH. Does housestaff discontinuity of care increase the risk for preventable adverse events? Ann Intern Med. 1994;121:866–72.

    Article  Google Scholar 

  11. Mukherjee S. A precarious exchange. N Engl J Med. 2004;351:1822–4.

    Article  Google Scholar 

  12. Agency for Healthcare Research and Quality. Patient safety primers: handoffs and signouts. http://www.psnet.ahrq.gov/primer.aspx?primerID=9. Accessed February 10, 2015.

  13. Accreditation Council for Graduate Medical Education. Common program requirements. http://www.acgme.org/acgmeweb/Portals/0/PFAssets/ProgramRequirements/CPRs2013.pdf. Accessed December 10, 2014.

  14. Gakhar B, Spencer AL. Using direct observation, formal evaluation, and an interactive curriculum to improve the sign-out practices of internal medicine interns. Acad Med. 2010;85:1182–8.

    Article  Google Scholar 

  15. DeRienzo CM, Frush K, Barfield ME, Gopwani PR, Griffith BC, Jiang X, et al. Handoffs in the era of duty hours reform: a focused review and strategy to address changes in the accreditation council for graduate medical education common program requirements. Acad Med. 2012;87:403–10.

    Article  Google Scholar 

  16. Gordon M. Training on handover of patient care within UK medical schools. Med educ online. 2013;18:1–5.

    Google Scholar 

  17. Solet DJ, Norvell JM, Rutan GH, Frankel RM. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med. 2005;80:1094–9.

    Article  Google Scholar 

  18. Farnan JM, Paro JA, Rodriguez RM, Reddy ST, Horwitz LI, Johnson JK, et al. Hand-off education and evaluation: piloting the observed simulated hand-off experience (OSHE). J Gen Intern Med. 2010;25:129–34.

    Article  Google Scholar 

  19. Chu ES, Reid M, Burden M, Mancini D, Schulz T, Keniston A, et al. Effectiveness of a course designed to teach handoffs to medical students. J Hosp Med. 2010;5:344–8.

    Article  Google Scholar 

  20. Darbyshire D, Gordon M, Baker P. Teaching handover of care to medical students. Clin Teach. 2013;10:32–7.

    Article  Google Scholar 

  21. Arora VM, Johnson JK, Meltzer DO, Humphrey HJ. A theoretical framework and competency-based approach to improving handoffs. Qual Saf Health Care. 2008;17(1):11–4.

    Article  Google Scholar 

  22. Humphris GM, Kaney S. Assessing the development of communication skills in undergraduate medical students. Med Educ. 2001;35:225–31.

    Article  Google Scholar 

  23. Gordon M, Findley R. Educational interventions to improve handover in health care: a systematic review. Med Educ. 2011;45:1081–9.

    Article  Google Scholar 

  24. Chang VY, Arora VM, Lev-Ari S, D’Arcy M, Keysar B. Interns overestimate the effectiveness of their hand-off communication. Pediatrics. 2010;125:491–6.

    Article  Google Scholar 

  25. Cleland JA, Ross S, Miller SC, Patey R. “There is a chain of chinese whispers…”: empirical data support the call to formally teach handover to prequalification doctors. Qual Saf Health Care. 2009;18:267–71.

    Article  Google Scholar 

  26. Shaughnessy EE. Pediatric resident sign-out education. https://www.mededportal.org/publication/8321. Accessed March, 2013.

  27. Shaughnessy EE, Ginsbach K, Groeschl N, Bragg D, Weisgerber M. Brief educational intervention improves content of intern handovers. J Grad Med Educ. 2013;5:150–3.

    Article  Google Scholar 

  28. Arora V, Johnson J. A model for building a standardized hand-off protocol. Jt Comm J Qual Patient Saf. 2006;32:646–55.

    Article  Google Scholar 

  29. Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005;14:401–7.

    Article  Google Scholar 

  30. WHO Collaborating Center for Patient Safety Solutions. Communication during patient hand-overs. http://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf. Accessed December 20, 2014.

  31. Chu ES, Reid M, Schulz T, Burden M, Mancini D, Ambardekar AV, et al. A structured handoff program for interns. Acad Med. 2009;84:347–52.

    Article  Google Scholar 

  32. Riesenberg LA, Leitzsch J, Massucci JL, Jaeger J, Rosenfeld JC, Patow C, et al. Residents’ and attending physicians’ handoffs: a systematic review of the literature. Acad Med. 2009;84:1775–87.

    Article  Google Scholar 

  33. Starmer AJ, Spector ND, Srivastava R, West DC, Rosenbluth G, Allen AD, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371:1803–12.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA

    Kris Saudek

  2. Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    Robert Treat

Authors
  1. Kris Saudek
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Correspondence to Kris Saudek.

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Funding/Support

This study was funded in part by a Medical College of Wisconsin Learning Resource Fund grant PRO00019619.

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

This study was approved by the institutional review board of the Medical College of Wisconsin/Froedtert Hospital.

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Saudek, K., Treat, R. Does Medical Student Hand-Over Training on a Third-Year Pediatric Clerkship Improves Skill and Confidence Level?. Med.Sci.Educ. 26, 649–655 (2016). https://doi.org/10.1007/s40670-016-0327-7

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