Interview with Dr Christopher J. Smith

Posted Mon, Aug, 24,2015


This author interview is by Dr Christopher J. Smith, of University of Nebraska College of Medicine. Dr Smith's full paper, Assessment of a Brief Handoff Skills Workshop for Incoming Interns: Do Past Handoff Experiences Impact Training Outcomes? is available for download in Journal of Medical Education and Curricular Development.



Please summarise for readers the content of your article.
We conducted a one-hour interactive handoff training session for incoming residents at a Midwestern academic medical center and performed pre/post-intervention assessments of participants' attitudes and ability to perform representative handoff skills. We also collected information on participants' baseline characteristics, including past handoff experiences, to see if they were associated with differences in training outcomes. We found that there was significant improvement in participants' self-assessment of handoff competency and their ability to perform core handoff activities regardless of prior handoff training, number of handoffs observed, number of handoffs performed, medical school, or residency discipline.

How did you come to be involved in your area of study?
I was a chief resident in 2011 when the ACGME work hour restrictions were implemented. These regulations greatly increased the number of handoffs within our residency program, so I designed and implemented a structured handoff process to minimize errors during transitions of care.

What was previously known about the topic of your article?
The AAMC recently identified handoffs as a core entrustable activity for graduating medical students, but few medical schools have handoff curricula. Even when medical student undergo handoff training, there is some evidence that they may not retail their skills in following months, supporting the need for education prior to entering residency. Although there is evidence that a day-long handoff workshop for incoming inters can improve self-reported attitudes, time constraints may limit its applicability, and the influence of participants' prior handoff experiences is unclear.

How has your work in this area advanced understanding of the topic?
We show that a brief, evidenced-based educational intervention is effective in improving interns' self-assessment of handoff competency and their ability to perform core handoff activities regardless of their prior training, number of handoffs observed, or number of handoffs performed. This study adds to the literature, as our findings support the need for handoff training for all interns immediately before beginning their residency programs.

What do you regard as being the most important aspect of the results reported in the article?
Even interns with past training and real-world practice benefited from handoff education prior to starting residency. Such "just-in-time" training provides learners a basic skill-set which can be built upon by their respective residency programs and also teaches them about the institution-specific expectations, policies, and practices (a requirement of the ACGME Clinical Learning Environment Review).

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