Handover training for medical students: a controlled educational trial of a pilot curriculum in Germany.

OBJECTIVE: The aim of this study was to implement and evaluate a newly developed standardised handover curriculum for medical students. We sought to assess its effect on students' awareness, confidence and knowledge regarding handover. DESIGN: A controlled educational research study. SETTING: The pilot handover training curriculum was integrated into a curriculum led by the Departments of Anesthesiology and Intensive Care (AI) at the University Hospital. It consisted of three modules integrated into a 4-week course of AI. Multiple types of handover settings namely end-of-shift, operating room/postanaesthesia recovery unit, intensive care unit, telephone and discharge were addressed. PARTICIPANTS: A total of n=147 fourth-year medical students participated in this study, who received either the current standard existing curriculum (no teaching of handover, n=78) or the curriculum that incorporated the pilot handover training (n=69). OUTCOME MEASURES: Paper-based questionnaires regarding attitude, confidence and knowledge towards handover and patient safety were used for pre-assessment and post-assessment. RESULTS: Students showed a significant increase in knowledge (p<0.01) and self-confidence for the use of standardised handover tools (p<0.01) as well as accurate handover performance (p<0.01) among the pilot group. CONCLUSION: We implemented and evaluated a pilot curriculum for undergraduate handover training. Students displayed a significant increase in knowledge and self-confidence for the use of standardised handover tools and accuracy in handover performance. Further studies should evaluate whether the observed effect is sustained across time and is associated with patient benefit.

[Patient handoffs in undergraduate medical education: A systematic analysis of training needs]. / Patientenübergaben in der Ausbildung? Eine systematische Analyse des Trainingsbedarfs unter Medizinstudierenden.

BACKGROUND: Insufficient handoffs lead to an increase in the risk of complications and malpractice, treatment delays, prolonged hospital stays, costs and patient complaints. The German Society for Anesthesiology and Intensive Care (DGAI) and the European Resuscitation Council (ERC) recommend the implementation of a communication procedure according to the SBAR concept. So far, there have been few curricular requirements in Germany regarding handoffs. METHODS: As part of the EU-funded PATIENT project an online-based cross-sectional needs analysis was conducted in three countries. In Aachen, 237 medical students answered 45 items concerning handoffs in three sections: A: skills (relevance and self-assessment), B: clinical experience (agreement), C: curricula content (presence and relevance). Data was recorded using a Likert scale (0-7). RESULTS: The students rated an adequate handoff performance as highly important (M=6.8; SD: ±0.6) and their own expertise as low (M=4.0; SD: ±1.3). A high training need was identified for writing discharge letters and performing accurate handoffs. The students were aware of the link between adequate handoffs and patient safety (M=6.5; SD: ±0.9). They considered standardized handoff procedures as an important curricular component (M=6.1; SD: ±1.1). From their point of view, the handling of medical errors is underrepresented in the curriculum (61.7 %). CONCLUSION: A need for handoff training was revealed, especially regarding transfers and discharges. Accordingly, learning objectives were determined and training modules developed and integrated into the curriculum in Aachen.