Internal medicine postgraduate training and assessment of patient handoff skills Journal Article

Authors: Didwania, A.; Kriss, M.; Cohen, E. R.; McGaghie, W. C.; Wayne, D. B.
Article Title: Internal medicine postgraduate training and assessment of patient handoff skills
Abstract: BACKGROUND: Effective communication during patient care transitions is essential for high-quality patient care. OBJECTIVE: The purpose of this study was (1) to objectively assess patient handoff skills of internal medicine residents, and (2) to evaluate correlations between clinical experience and patient handoff skill self-assessment with directly observed skill. METHODS: We studied simulated patient handoffs in postgraduate year (PGY)-1 and PGY-2 residents between July 2011 and September 2011, using a standardized scenario in an observed structured handoff exam (OSHE). Our design was a posttest-only, with nonequivalent groups. Assessment used a previously published checklist for evaluating handoff skills. Residents were asked about clinical experience with patient handoffs and about their self-confidence in performing a patient handoff independently. We evaluated between-group differences on OSHE checklist performance, patient handoff experience, and self-confidence and used multiple regression analyses to assess the association between performance, experience, and confidence. RESULTS: Forty-seven PGY-1 residents and 38 PGY-2 residents completed the study. Interrater reliability was substantial (intraclass correlation = 0.68). There was no significant difference in OSHE performance by PGY-1 residents (mean = 79%, SD = 4.6) and PGY-2 residents (mean = 82%; SD = 7.6; P = .07). The PGY-2 residents were significantly more experienced (P .001) and confident (P .001) than PGY-1 residents were, yet clinical experience and self-confidence did not significantly predict OSHE performance. CONCLUSIONS: Clinical experience and self-assessment do not predict skills in simulated patient handoffs, and residents with substantial clinical experience still benefit from further skills development.
Journal Title: Journal of graduate medical education
Volume: 5
Issue: 3
ISSN: 1949-8349; 1949-8357
Publisher: Unknown  
Journal Place: United States
Date Published: 2013
Start Page: 394
End Page: 398
Language: eng
Notes: LR: 20140113; JID: 101521733; OID: NLM: PMC3771167 [Available on 09/01/14]; PMCR: 2014/09/01 00:00; 2012/07/22 [received]; 2012/10/25 [revised]; 2012/11/20 [accepted]; ppublish