Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents

Lescinskas, Erica; Stewart, D J; Shah, Chirayu

doi:10.4300/jgme-d-18-00244.1

Cited by 8 publications

(6 citation statements)

References 9 publications

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“…The ACGME Clinical Learning Environment Review outlines the need for education in care transitions and standardized handoffs in resident education (ACGME, 2018). Studies support the utilization of standardized handoff training and formats as these interventions have been shown to increase trainee comfort and decrease medical errors (Lescinskas, Stewart and Shah, 2018;Starmer et al, 2014).…”

Section: Standardize Socially Distanced Sign-outsmentioning

confidence: 99%

Tips for pandemic response planning for Internal Medicine training programs

Spitzer¹,

Allen²,

Sinha³

et al. 2020

MedEdPublish

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The current Coronavirus Disease 2019 (COVID-19) pandemic has strained hospital systems and training programs across the world. As capacity issues mount and trainees are called upon to provide frontline medical care, programs and institutions have had to rapidly evolve to redefine the trainee experience. To that end, there is a paucity of literature regarding how healthcare training programs should operate during a global pandemic. Here, we aim to describe twelve evidence-based recommendations for coordinating a cohesive, systematic approach to pandemic response planning for Internal Medicine residency training programs. These tips encompass inpatient and outpatient practices, provider safety, resuscitation, virtual education programming and resident wellbeing. Though many of these considerations or recommendations were not described during the COVID-19 pandemic, these tips have been described previously in the literature, are applicable to the current pandemic and could be easily extrapolated to future crises.

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Section: Standardize Socially Distanced Sign-outsmentioning

confidence: 99%

Tips for pandemic response planning for Internal Medicine training programs

Spitzer¹,

Allen²,

Sinha³

et al. 2020

MedEdPublish

View full text Add to dashboard Cite

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“…Recent reports have indicated that engaging students in vocation-oriented internships and placements are an effective way to enhance their professional skills and employability. Internship experiences help students increase their opportunities for different positions after they graduate from university, regardless of their university majors, but particularly if they graduate with non-vocation-oriented degrees [31,32]. Graduates with internship experience are more likely to be chosen for interviews than those without such experience [33].…”

Section: Literature Reviewmentioning

confidence: 99%

Rural Public Health Workforce Training and Development: The Performance of an Undergraduate Internship Programme in a Rural Hospital and Healthcare Centre

Santos

2019

IJERPH

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Workforce shortages in the field of public health and healthcare are significant. Due to the limitations of career opportunities and compensation, rural hospitals and healthcare centres usually have on-going career openings for all departments. As a result, university departments of public health and healthcare management, and rural hospitals and health centres may need to establish internship and training programmes for undergraduate senior-year students in order to provide opportunities and human resource opportunities for both students and public health professions. The research examined the performance, feedback, and opinions of a university-based one-year-long on-site internship training programme between a university public health and healthcare undergraduate department and a regional hospital and healthcare centre in a rural region in the United States. Individual interview data were collected from management trainees and focus group activities data were collected from hospital departmental supervisors who have completed this one-year-long on-site internship training programme. The results offered an assessment of performance and evaluation of how a one-year-long internship programme could be beneficial to hospitals and health centres in the areas of human resources, manpower management, and skill training to prospective professionals in rural and regional communities. Also, the study provided a blueprint and alternative for universities and partnered sites to redesign and improve their current internship programmes which may better fit their needs for their actual situations.

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“…Previous studies have confirmed the importance of providing residents with structured training about TOC mnemonic use via interventions such as bootcamps, didactic sessions, and/or simulated learning experiences, but little research is available on TOC postintervention reinforcement via direct observation of actual patient encounters. 12,13 Our expectation was that use of a direct observation instrument, Transitions of Care-Clinical Evaluation Exercise (TOC-CEX), by faculty as both a monitoring and education tool would increase awareness and adoption of TOCs as a practice habit and contribute to culture change in the clinical learning environment.…”

Section: Introductionmentioning

confidence: 99%

Using a Direct Observation Tool (TOC-CEX) to Standardize Transitions of Care by Residents at a Community Hospital

Kenaga

Markova

Stansfield

et al. 2021

TOJ

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Background: High-quality transitions of care are crucial for patient safety in hospitals, yet few undergraduate curricula include transition-of-care training. In 2012, the Wayne State University Office of Graduate Medical Education (WSUGME) required its residency programs to use the SAIF-IR mnemonic (summary, active issues, if-then contingency planning, follow-up activities, interactive questioning, readback) to ensure accurate and uniform handoffs. Subsequent program evaluations indicated that resident awareness and adoption of the mnemonic at our primary clinical site, Ascension Providence Rochester Hospital (APRH), could be improved. According to our institution's 2016 Clinical Learning Environment Review (CLER), 88% of residents reported following a standardized transition of care handoff, and 53% reported that faculty rarely supervised their handoffs. A 2016 WSUGME internal survey also revealed low rates of awareness (7% to 10%) of the mandated mnemonic. WSUGME then created a direct observation tool, the Transitions of Care-Clinical Evaluation Exercise (TOC-CEX), for faculty to monitor resident skill in using the mnemonic and thus standardize transitions of care as a practice habit at APRH. Methods: Since 2014, WSUGME had relied on 2 methods for training residents in the required handoff mnemonic: (1) introduction to the SAIF-IR mnemonic during the WSUGME orientation for all interns and (2) simulations during an objective simulated handoff evaluation activity for all postgraduate year (PGY) 1s and PGY 2s. In 2017, WSUGME innovated a direct observation tool, the TOC-CEX, for adoption by faculty at APRH to assess resident knowledge of and monitor their skill in using the SAIF-IR mnemonic in 3 primary care programs. The total number of possible participants was 138, and the actual number of individuals in the sample was 95. A majority (86%) of the observations during the study period were of PGY 1 residents, and thus the analysis reflects the ratings of 99% of all interns but only 69% of all possible residents. Results: WSUGME found that faculty use of a direct observation instrument in the clinical learning environment during 2017-2019 increased awareness and adoption of the SAIF-IR mnemonic among residents. Using a z-test of equal proportions on resident responses on an internal WSUGME survey, we found a significant rise in the percentage reporting yes to the question "Does your program have a mechanism for monitoring handoffs?" (χ 2 [3]=23.6, P<0.0001) and in the percentage identifying SAIF-IR in response to the question "Does your program endorse a specific mnemonic for organizing the contents of a verbal handoff?" (χ 2 [3]=45.0, P<0.0001). The increase from 2016 to 2017 is the result of the implementation of the TOC-CEX in the interim (question 1: χ 2 [1]=12.4, P<0.0005; question 2: χ 2 [1]=10.1, P<0.0025). Conclusion: Our research found that use of the TOC-CEX to monitor resident handoffs resulted in improved awareness and adoption of the SAIF-IR mnemonic in the clinical learning environment. Program lead...

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Improving Handoffs: Implementing a Training Program for Incoming Internal Medicine Residents

Cited by 8 publications

References 9 publications

Tips for pandemic response planning for Internal Medicine training programs

Tips for pandemic response planning for Internal Medicine training programs

Rural Public Health Workforce Training and Development: The Performance of an Undergraduate Internship Programme in a Rural Hospital and Healthcare Centre

Using a Direct Observation Tool (TOC-CEX) to Standardize Transitions of Care by Residents at a Community Hospital

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