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Abstract
Background Poor communication between healthcare professionals is recognised as accounting for a significant proportion of adverse patient outcomes. In the UK, the General Medical Council emphasises effective handover (handoff) as an essential outcome for medical graduates. Despite this, a significant proportion of medical schools do not teach the skill.
Objectives This study had two aims: (1) demonstrate a need for formal handover training through assessing the pre-existing knowledge, skills and attitudes of medical students and (2) study the effectiveness of a pilot educational handover workshop on improving confidence and competence in structured handover skills.
Design Students underwent an Objective Structured Clinical Examination style handover competency assessment before and after attending a handover workshop underpinned by educational theory. Participants also completed questionnaires before and after the workshop. The tool used to measure competency was developed through a modified Delphi process.
Setting Medical education departments within National Health Service (NHS) Lanarkshire hospitals.
Participants Forty-two undergraduate medical students rotating through their medical and surgical placements within NHS Lanarkshire enrolled in the study. Forty-one students completed all aspects.
Main outcome measures Paired questionnaires, preworkshop and postworkshop, ascertained prior teaching and confidence in handover skills. The questionnaires also elicited the student’s views on the importance of handover and the potential effects on patient safety. The assessment tool measured competency over 12 domains.
Results Eighty-three per cent of participants reported no previous handover teaching. There was a significant improvement, p<0.0001, in confidence in delivering handovers after attending the workshop. Student performance in the handover competency assessment showed a significant improvement (p<0.05) in 10 out of the 12 measured handover competency domains.
Conclusions A simple, robust and reproducible intervention, underpinned by medical education theory, can significantly improve competence and confidence in medical handover. Further research is required to assess long-term outcomes as student’s transition from undergraduate to postgraduate training.
- medical education & training
- change management
- statistics & research methods
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Footnotes
NH and KC are co-first authors.
Twitter @drnick_holt
NH and KC contributed equally.
Contributors NH: MBChB, MRCP, MRCPS(Glas), PGCert Med Ed, Honorary Clinical Lecturer (University of Glasgow), Clinical Teaching fellow in NHS Lanarkshire. I declare that I made substantial contributions to the conception and design of the work, the acquisition and interpretation of the data. I made a significant contribution to the drafting and revision of the work and give approval for the final piece to be published. I agree to be accountable for all aspects of the work and will investigate and resolve any questions that arise. KC: BMedSci (Hons), MBChB (Hons) MRCP, Honorary Clinical Lecturer (University of Glasgow), PGCert Med Ed, Clinical Teaching Fellow in NHS Lanarkshire. I declare that I made substantial contributions to the conception and design of the work, the acquisition and interpretation of the data. I made a significant contribution to the drafting and revision of the work and give approval for the final piece to be published. I agree to be accountable for all aspects of the work and will investigate and resolve any questions that arise. DL: MBChB (Hons), MRCP, MRCPS(Glas), Honorary Clinical Lecturer (University of Glasgow), PGCert Med Ed, Clinical Teaching Fellow in NHS Lanarkshire. I declare that I made substantial contributions to the conception and design of the work, the acquisition and interpretation of the data. I made a significant contribution to the drafting and revision of the work and give approval for the final piece to be published. I agree to be accountable for all aspects of the work and will investigate and resolve any questions that arise. ZH: BSc (Hons) Medicine, MBChB, MRCEM, PG Diploma Health Professions Education, Honorary Clinical Lecturer (University of Glasgow), Clinical Simulation Fellow in NHS LanarkshireI declare that I made substantial contributions to the conception and design of the work, the acquisition and interpretation of the data. I made a significant contribution to the drafting and revision of the work and give approval for the final piece to be published. I agree to be accountable for all aspects of the work and will investigate and resolve any questions that arise.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This project was granted ethical approval from the University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee in December 2018, ID number 200 180 052.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.