SAN FRANCISCO – A 1-day course with simulated intraoperative handoffs improved the rate of failed communications from 30% before the course to 17% immediately after the course, with a further improvement 1 year later to a 13% failure rate in a study of 10 anesthesiology residents.
The course combined simulation-based education, which has been used previously to train residents on postoperative handoffs, and deliberate practice, an educational strategy that has been used previously to teach technical skills to residents. Each resident in the study performed a simulated intraoperative handoff, followed by a debriefing with the whole group and individual feedback on the handoff performance. Participants together discussed barriers to effective communication and created an intraoperative handoff checklist. Each resident then repeated a simulated handoff to practice with the checklist.
One year later, 7 of the 10 residents did another simulated intraoperative handoff that was recorded on video and scored by trained raters using a handoff assessment tool to characterize the type and frequency of communication failures.
Before the course, none of the 10 residents knew the Joint Commission definition of a handoff, and none knew that patient handoff communication was a patient safety goal of the Joint Commission. A year later, all seven residents could accurately define the Joint Commission goal, Dr. Erin W. Pukenas reported in a poster presentation at the annual meeting of the American Society of Anesthesiologists.
At the beginning of the course, residents had set individual communication goals for handoffs. Forty-six percent said they wanted to develop a more systematic approach to their handoffs, and 31% wanted to be more thorough in their handoffs. A year later, all residents said they had met or exceeded their goals, reported Dr. Pukenas of Rowan University, Camden, N.J.
The study was the first to assess retention of knowledge and skills 1 year after the course was added to the curriculum, she said.
Investigators may next study the effects of simulation-based handoff education and deliberate practice on handoff communications in clinical settings, she said.
The Accreditation Council for Graduate Medical Education requires handoff training for all medical residents.
Dr. Pukenas reported having no relevant financial disclosures.
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