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Research Article Open Access
Introduction: In order to properly educate residents about the communication components involved in effective handoff delivery, interventions that promote demonstration of skill with real-time feedback are essential. Our institution developed a focused intervention for all residency programs to improve handoff education by implementing standardized written and verbal templates throughout all specialties. We decided upon a common framework for education and evaluation of resident handoff competency: the objective simulated handoff evaluation (OSHE) originally developed by Farnan et al. Handoffs are critically important for patient quality of care and safety. Methods:Residents completed the objective simulated handoff evaluation in pairs where the junior resident completed a verbal and written hand off using a simulated case to a senior resident in the same specialty. The senior residents provided feedback on the verbal handoff and faculty scored the written templates. The junior residents were surveyed pre-and-post to assess resident handoff education prior to the exercise and to gather feedback. Results: Residents rated their ability to pick up a new service significantly higher after the objective simulated handoff evaluation, (Mdn=4), U=308, p=0.005, r=0.34, in contrast to their initial rating (Mdn=3). Additionally, residents reported higher confidence in making contingency plans, (Mdn=4), U=311, p=0.005, r=0.35, compared to baseline (Mdn=3). Performing a read back showed improvement, (Mdn=4), U=321, p=0.01, r=0.31, when compared to the pre-survey (Mdn=3). Finally, when to perform a read-back also improved post-objective simulated handoff evaluation, (Mdn=4), U=323, p=0.01, r=0.32, when compared to the baseline (Mdn=3). Conclusion: Our institution-wide focus on standardization demonstrated that residency programs can collaborate productively despite their specialty-specific differences in transfers of care. Handoff education is essential in positively affecting patient care.
OSHE, Handoff skills, Resident handoff education, Transitions of care education, Simulation education, Resident communication skills, Graduate medical education, Emergency Care,General Practitioner