Development and Implementation of an Oral Sign-out Skills Curriculum

Horwitz, Leora I.; Moin, Tannaz; Green, Michael L.

doi:10.1007/s11606-007-0331-0

Cited by 148 publications

(131 citation statements)

References 33 publications

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“…While several methods of teaching and evaluating handoffs have been previously described in the literature, 16,19,20,24,25 this study is the first to utilize a multi-patient, simulation-based assessment targeting incoming residents. Our results suggest that this may be a promising strategy to provide continuity in handoff training during the transition from undergraduate to graduate medical education and to identify incoming residents in need of additional practice.…”

Section: Discussionmentioning

confidence: 99%

“…Each behavior was chosen after careful review and deliberation of well-publicized work in this area, 16,[19][20][21] previously validated tools to evaluate handoffs such as the Hand-off CEX, 22 and the recommendations for handoffs outlined by the Society of Hospital Medicine. 23 Four of these behaviors were directly taken from the Handoff CEX.…”

Section: Program Descriptionmentioning

confidence: 99%

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The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

et al. 2016

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BACKGROUND: Despite the identification of transfer of patient responsibility as a Core Entrustable Professional Activity for Entering Residency, rigorous methods to evaluate incoming residents' ability to give a verbal handoff of multiple patients are lacking. AIM: Our purpose was to implement a multi-patient, simulation-based curriculum to assess verbal handoff performance. SETTING: Graduate Medical Education (GME) orientation at an urban, academic medical center. PARTICIPANTS: Eighty-four incoming residents from four residency programs participated in the study. PROGRAM DESCRIPTION: The curriculum featured an online training module and a multi-patient observed simulated handoff experience (M-OSHE). Participants verbally Bhanded off^three mock patients of varying acuity and were evaluated by a trained Breceiver^using an expertinformed, five-item checklist. PROGRAM EVALUATION: Prior handoff experience in medical school was associated with higher checklist scores (23 % none vs. 33 % either third OR fourth year vs. 58 % third AND fourth year, p = 0.021). Prior training was associated with prioritization of patients based on acuity (12 % no training vs. 38 % prior training, p = 0.014). All participants agreed that the M-OSHE realistically portrayed a clinical setting. CONCLUSIONS: The M-OSHE is a promising strategy for teaching and evaluating entering residents' ability to give verbal handoffs of multiple patients. Prior training and more handoff experience was associated with higher performance, which suggests that additional handoff training in medical school may be of benefit.KEY WORDS: medical education; medical student and residency education; communication skills.

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Section: Discussionmentioning

confidence: 99%

Section: Program Descriptionmentioning

confidence: 99%

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

et al. 2016

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“…8 Although formal training on discharge care was not included as part of SBP at either residency, both sites have specific training on "handoffs" through noon conference lectures, and a formal sign-out tool is used at one site to guide these handoffs. 17 To ensure adequate representation by post-graduate year, gender, and experience in diverse training settings, we invited participation from residents at both sites who had completed an inpatient ward rotation at any site in their program within the preceding 6 months. Invitations were sent by program directors via email to all trainees in both programs and we received replies from 31 residents total.…”

Section: Study Design and Samplementioning

confidence: 99%

“…10 Recent duty hour regulations 11,12 have also heightened these challenges and drawn increased attention to transitions of care at teaching hospitals. 13 Although studies of inpatient transitions, such emergency departmentto-floor 14 or dayshift-to-nightshift handoff practices for inpatient units, 15,16 have already informed curricular changes at residency programs, 17 we have very limited data about resident practices at the point of discharge. Recently, we described quality-limiting factors in discharge care at teaching hospitals; however, information is still lacking about how residents learn to provide high-quality discharge care.…”

Section: Introductionmentioning

confidence: 99%

“Learning by Doing”—Resident Perspectives on Developing Competency in High-Quality Discharge Care

et al. 2012

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BACKGROUND: Reducing readmissions and post-discharge adverse events by improving the quality of discharge care has become a national priority, yet we have limited understanding about how physicians learn to provide high-quality discharge care. METHODS: We conducted in-depth, in-person interviews with housestaff physicians with qualitative analysis by a multi-disciplinary team using the constant comparative method to explore learning about highquality discharge care as a systems-based practice and to identify opportunities to improve training around these concepts. RESULTS: We analyzed interview transcripts from 29 internal medicine residents: 17 (59 %) were interns (PGY-2 or PGY-3), 12 (41 %) seniors, and 17 (59 %) were female. We identified a recurrent theme of lack of formal training about the discharge process, substantial peerto-peer instruction, and "learning by doing" on the wards. Within this theme, we identified five specific concepts related to systems-based practice and highquality discharge care which residents learned during residency: (1) teamwork and the interdisciplinary nature of discharge planning; (2) advanced planning strategies to anticipate challenges in the discharge process; (3) patient safety and the concept of a "safe discharge;" (4) patient continuity of care and learning from post-discharge outcomes and; (5) documentation of discharge plans as a valuable skill. CONCLUSIONS: Discharge care is an overlooked opportunity to teach concepts of systems-based practice explicitly as learning about discharge care is unstructured and individual experiences may vary considerably. Educational interventions to standardize learning about discharge care may improve the development of systems-based practice during residency and help improve the overall quality of discharge care at teaching hospitals.KEY WORDS: discharge care; quality of care; core competencies; residency education.

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“…2,3 Recognizing such findings, a growing body of literature addresses handoff techniques for learners. [4][5][6][7] Vidyarthi described the handoff process as ''traditionally informal, unstructured, and idiosyncratic,'' 4 and many believe efforts to formalize and structure this process are important for patient safety. 8 Standardized handoff forms have improved accuracy of information.…”

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confidence: 99%

Gaining efficiency and satisfaction in the handoff process

Burton

Kashiwagi

Kirkland

et al. 2010

Journal of Hospital Medicine

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BACKGROUND:Handoffs, or transfers of patient care responsibility, occur frequently on hospitalist teams. The reliability and efficiency of the handoff process is a national and local concern. Most studies in the literature regard physicians‐in‐training. We studied the morning handoff process of hospitalist teams comprised of staff physicians and nurse practitioner and/or physician assistants.METHODS:An improvement team observed morning handoffs. Four problems were identified: unpredictable start and finish times, inefficiency, poor environment (hallway noise and distracting in‐room conversations), and poor communication. The team restructured the process and observed post‐intervention behavior at 15 and 90 days. A participant‐provider survey was conducted before and after the intervention regarding wasted time, total time‐in‐report, and satisfaction with the process.RESULTS:Pre‐intervention 60.5% of providers (23/38) believed morning handoff was performed in a timely fashion compared to 100% (15/15) post‐intervention (P = 0.005). Average time spent in morning report was 11 minutes, compared to 5 minutes after the intervention (P < 0.0028). Pre‐intervention 6.5 minutes were believed wasteful, compared to 0.5 minutes post‐intervention (P < 0.0001).CONCLUSIONS:This study identifies deficiencies in the handoff process that were addressed by enhancing the physical environment (smaller room, noise reduction, closed door), assigned seating (visual cues by table tent cards), non‐clinicians providing printed materials, standardization of written updates, team times (consistent & precise daily time for each team report), culture change including deference of attention to team receiving report with opportunity for questions, and minimization of side conversations. This intervention package resulted in an improvement in satisfaction and timeliness of clinicians involved. Journal of Hospital Medicine 2010. © 2010 Society of Hospital Medicine.

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Development and Implementation of an Oral Sign-out Skills Curriculum

Abstract: 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.

Cited by 148 publications

References 33 publications

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance

“Learning by Doing”—Resident Perspectives on Developing Competency in High-Quality Discharge Care

Gaining efficiency and satisfaction in the handoff process

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