Communication errors during shift-to-shift handoffs are a leading cause of preventable adverse events. Nevertheless, handoff skills are variably taught at medical schools. The authors administered questionnaires on handoffs to interns during orientation. Questions focused on medical school handoff education, experiences, and perceptions. The majority (546/718) reported having some form of education on handoffs during medical school, with 48% indicating this was 1 hour or less. Most respondents (98%) reported that they believe patients experience adverse events because of inadequate handoffs, and more than one third had witnessed a patient safety issue. Results show that medical school graduates are not receiving adequate handoff training. Yet graduates are expected to conduct safe patient handoffs at the start of residency. Given that ineffective handoffs pose a significant patient safety risk, medical school graduates should have a baseline competency in handoff skills. This will require medical schools to develop, implement, and study handoff education.
World Health Organization. The WHO Collaborating Centre on Patient Safety (Solutions), the World Alliance for Patient Safety and the Commonwealth Fund Announce Action on Patient Safety (High 5s) Initiative. http://www.who.int/patientsafety/news/High_5_Release.pdf. Accessed May 1, 2017.
JensenAMSandersCDotyJHigbeeDRawlingsAL. Characterizing information decay in patient handoffs. J Surg Educ. 2014;71:480-485.
10.
Lyss-LermanPTeheraniAAagaardELoeserHCookeMHarperGM. What training is needed in the fourth year of medical school? Views of residency program directors. Acad Med. 2009;84:823-829.
11.
AngusSVuTRHalvorsenAJ. What skills should new Internal Medicine interns have in July? A national survey of internal medicine residency directors. Acad Med. 2014;89:432-435.
12.
PereiraAGHarrellHEWeissmanASmithCDDuprasDKaneGC. Important skills for internship and the fourth-year medical school courses to acquire them: a national survey of internal medicine residents. Acad Med. 2016;91:821-826.
13.
SinghHThomasEJPetersenLAStuddertDM. Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. Arch Intern Med. 2007;167:2030-2036.
14.
AroraVMEastmentMCBetheaEDFarnanJMFriedmanES. Participation and experience of third-year medical students in handoffs: time to sign out?J Gen Intern Med. 2013;28:994-998.
15.
SoletDJNorvellJMRutanGHFrankelRM. Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs. Acad Med. 2005;80:1094-1099.
16.
ten CateOYoungJQ. The patient handover as an entrustable professional activity: adding meaning in teaching and practice. BMJ Qual Saf. 2012;21(suppl 1):i9-i12.
17.
StarmerAJSpectorNDSrivastavaR. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371:1803-1812.
18.
ListonBWTartagliaKMEvansDWalkerCTorreD. Handoff practices in undergraduate medical education. J Gen Intern Med. 2014;29:765-769.
LazarusMDDos SantosJAHaidetPMWhitcombTL. Practicing handoffs early: applying a clinical framework in the anatomy laboratory. Anat Sci Educ. 2016;9:476-487.
21.
MorzinskiJATothHSimpsonDYoungSMarcdanteK. Students’ critical incidents point the way to safer patient care transitions. WMJ. 2016;115:81-85.
22.
BurnsRAdlerMMangoldKTrainorJ. A brief boot camp for 4th-year medical students entering into pediatric and family medicine residencies. Cureus. 2016;8(2):e488.
23.
ReyesJAGreenbergLAmdurRGehringJLeskyLG. Effect of handoff skills training for students during the medicine clerkship: a quasi-randomized study. Adv Health Sci Educ Theory Pract. 2016;21:163-173.
24.
FarnanJMParoJARodriguezRM. Hand-off education and evaluation: piloting the observed simulated hand-off experience (OSHE). J Gen Intern Med. 2009;25:129-134.
25.
KlamenDLReynoldKLYaleBAielloM. Students learning handovers in a simulated in-patient unit. Med Educ. 2009;43:1097-1098.
26.
ChuESReidMBurdenM. Effectiveness of a course designed to teach handoffs to medical students. J Hosp Med. 2010;5:344-348.
27.
AllenSCatonCCluverJMainousAGClyburnB. Targeting improvements in patient safety as a large academic center: an institutional handoff curriculum for graduate medical education. Acad Med. 2014;89:1366-1369.
28.
DavisJRoachCElliottCMardisMJusticeEMRiesenbergL. Feedback and assessment tools for handoffs: a systematic review. J Grad Med Educ. 2017;9:18-32.
29.
WinnASMarcusCHSectishTC. Association of American Medical Colleges core entrustable professional activities for entering residency: resident and attending physician perceived supervisory needs of new interns. Acad Med. 2016;91:S13.
30.
HauffSRHopsonLRLosmanE. Programmatic assessment of level 1 milestones in incoming interns. Acad Emer Med. 2014;21:694-698.
31.
StojanJNSchillerJHMullanP. Medical school handoff education improves postgraduate trainee performance and confidence. Med Teach. 2015;37:281-288.
32.
O’TooleJKStevensonATGoodBP. Closing the gap: a needs assessment of medical students and handoff training. J Pediatr. 2013;162:887-888.e1.
