MedEdPORTAL (Dec 2015)
ACCEPT Medical Student Handoff Workshop: The Patient Safety Curriculum Starts in Undergraduate Medical Education
Abstract
Abstract Introduction In recent years, the Accreditation Council for Graduate Medical Education introduced resident duty-hour regulations in an effort to reduce errors associated with sleep deprivation. A consequence of reduced duty hours has been greater discontinuity in patient care and a significant increase in the number of handoffs of patients to other physicians. At George Washington University, we conducted a quasi-randomized study of third-year internal medicine clerks receiving a standardized handoff skills training. At the core of the training was a workshop developed by a group of medical educators and hospitalists aimed at teaching third-year medical students a standardized approach to handoffs in the inpatient setting. This workshop consists of a 1-hour, interactive, small-group session facilitated by a faculty member. It focuses on the importance of specific handoff skills to patient safety and is centered on the principles embodied in the ACCEPT mnemonic: accurate, complete (but concise), clear, efficient, presented in writing, and told in person. Methods Students are provided with a standardized format for both an oral and written handoff along with a pocket card highlighting the required elements. A standardized patient case allows for participants to practice these skills, receive feedback, and undergo formal evaluation. Results Using a handoff evaluation tool, we found that students who participated in the workshop demonstrated an improvement in their oral handoff skills. After a follow-up 9 months later, trained students performed statistically significantly better than untrained controls. Lastly, trained students transferred the skills they were taught to the clinical setting and performed statistically significantly better than untrained controls when assessed doing real-time handoffs during their acting-internship. Student self-assessment found that 72% of students felt at least somewhat unprepared to perform an effective handoff prior to participating in the educational workshop, while 75% of students felt well prepared or very well prepared after the educational intervention. Eighty-six percent of the students felt the educational intervention to be effective. No student reported that the workshop was ineffective. Discussion The primary goal of the workshop is to provide a brief but effective handoff-skills training session that can be targeted to participants as early as the third year of medical school. The workshop was designed to be time efficient, limit faculty resource utilization, and have a lasting impact.
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