BackgroundPoor communication between healthcare professionals is recognised as accounting for a significant proportion of adverse patient outcomes. In the UK, the General Medical Council emphasises effective handover (handoff) as an essential outcome for medical graduates. Despite this, a significant proportion of medical schools do not teach the skill.ObjectivesThis study had two aims: (1) demonstrate a need for formal handover training through assessing the pre-existing knowledge, skills and attitudes of medical students and (2) study the effectiveness of a pilot educational handover workshop on improving confidence and competence in structured handover skills.DesignStudents underwent an Objective Structured Clinical Examination style handover competency assessment before and after attending a handover workshop underpinned by educational theory. Participants also completed questionnaires before and after the workshop. The tool used to measure competency was developed through a modified Delphi process.SettingMedical education departments within National Health Service (NHS) Lanarkshire hospitals.ParticipantsForty-two undergraduate medical students rotating through their medical and surgical placements within NHS Lanarkshire enrolled in the study. Forty-one students completed all aspects.Main outcome measuresPaired questionnaires, preworkshop and postworkshop, ascertained prior teaching and confidence in handover skills. The questionnaires also elicited the student’s views on the importance of handover and the potential effects on patient safety. The assessment tool measured competency over 12 domains.ResultsEighty-three per cent of participants reported no previous handover teaching. There was a significant improvement, p<0.0001, in confidence in delivering handovers after attending the workshop. Student performance in the handover competency assessment showed a significant improvement (p<0.05) in 10 out of the 12 measured handover competency domains.ConclusionsA simple, robust and reproducible intervention, underpinned by medical education theory, can significantly improve competence and confidence in medical handover. Further research is required to assess long-term outcomes as student’s transition from undergraduate to postgraduate training.

BackgroundObjective assessment of medical handover skills is challenging. This short communication will illustrate the use of a modified Delphi technique in utilising both clinicians and educationalists to produce a fair and robust tool to assess medical student competence in handover. MethodUsing three rounds in a reactive Delphi process, two case-specific assessment tools were formulated. Round two involved clinical experts to respond to pre-defined criteria set in round 1, rather than being invited to develop their own benchmarks. Round 3 saw medical educationalists identify the components that a student should be expected to hand over at their stage of training. ResultsFor Case 1, twenty-eight initial key handover components were refined down to eighteen which were then encompassed in the final Case 1 assessment tool.For Case 2, thirty-one initial components were refined down to seven key handover components. These were then used to populate the final Case 2 assessment tool. DiscussionThrough the survey of clinical and medical education experts, the modified Delphi process allows the formation of a standardised assessment for individual handover scenarios, whilst ensuring a reflection of current clinical best practice. It is however, time consuming and the final tool is not necessarily faultless, as it invariably affected by the experiences and opinions of the group members. Continual validity judgements in assessment standardisation are essential.