A Standardized Handoff Simulation Promotes Recovery From Auditory Distractions in Resident Physicians. Issue 4 (August 2018)

• Record Type: Journal Article
• Authors: Matern, Lukas H.; Farnan, Jeanne M.; Hirsch, Kristen W.; Cappaert, Melissa; Byrne, Ellen S.; Arora, Vineet M.
• Is Part Of: Simulation in healthcare. Volume 13:Issue 4(2018)
• Publication Date: 2018-08
• Subjects: Handoffs -- patient safety -- graduate medical education -- simulation; Simulated patients -- Periodicals; 362.1
• DOI: 10.1097/SIH.0000000000000322
• Languages: English
• ISSNs: 1559-2332

Abstract

Abstract : Introduction: Despite the increasing use of training simulations to teach and assess resident handoffs, simulations that approximate realistic hospital conditions with distractions are lacking. This study explores the effects of a novel simulation-based training intervention on resident handoff performance in the face of prevalent hospital interruptions. Methods: After a preliminary educational module, entering postgraduate year 1 residents (interns) completed one of the following three handoff simulations: (1) no interruption, (2) hospital noise, or (3) noise and pager interruptions. Trained receivers rated interns using an evidence-based Handoff Behaviors Checklist and a previously validated Handoff Mini-Clinical Examination Exercise instrument. Results: Of 127 eligible interns, 125 (98.4%) completed an online preparatory module and a handoff simulation. Interns receiving auditory interruptions were less likely to be heard adequately (48.8% noise and 71.8% noise + pager vs. 100.0% uninterrupted, P < 0.001) and scored lower on establishing appropriate handoff settings (5.7 ± 2.3 noise and 6.2 ± 1.8 noise + pager vs. 8.0 ± 0.8 uninterrupted, P < 0.001). Interns receiving noise only shared a written sign-out document more effectively (71.1% vs. 30.2% uninterrupted and 43.6% noise + pager, P < 0.001). There were no differences in averaged performance metrics on the Handoff Behaviors Checklist. Discussion: While common hospital interruptions created nonideal circumstances for the handoff, interns receiving interruptions were rated similarly and recovered effectively. However, interns exposed to noise only used the written sign-out form more actively. Our findings suggest that this intervention was successful in promoting handoff proficiency despite exposure to common but significant hospital interruptions. Abstract : Supplemental digital content is available in the text.