A clinical decision report using: Simons-Linares CR, Barkin JA, Wang Y, et al. Is There an Effect of Cannabis Consumption on Acute Pancreatitis?. Dig Dis Sci. 2018;63(10):2786-2791. https://doi.org/10.1007/s10620-018-5169-2 for a patient with cannabis-associated acute pancreatitis.<strong></strong>
Background Dissection of the human body takes considerable time and effort, but also provides opportunities for the introduction of clinical skills. One skill is the safe transfer (handoff) of a patient between healthcare teams, a process dependent on the accurate exchange of information. In order to provide medical students with opportunities to practice skills in teamwork and communication while also reducing time spent in the dissection process, a handoff procedure was piloted for use in the gross anatomy laboratory. This study reports initial findings on student perceptions of time usage, wellness, teamwork & communication skills, and relevance to patient handoff, as well as impact on learning and performance through analysis of assessment data. Methods First‐year medical students (n=296) at Wayne State University were briefed on how to complete handoffs and their fundamental role in care of future patients. Each anatomy group was divided into two groups, which alternated between roles as the “dissecting‐team” and “receiving‐team.” A handoff tool was developed and included written and verbal components. The written component included a standardized checklist, designed as a lab chart to ensure dissection as well as mimic a handoff document. During the verbal component, the dissecting‐team demonstrated structures to the receiving‐team and shared anticipated problems. The handoff trial took place during 10‐dissection labs covering the head and neck region. Students were asked to complete a presurvey prior to starting and a postsurvey after completing the handoff curriculum. Responses to the pre‐ and post‐ surveys were 59% and 61% of the class, respectively. Results On the presurvey, 71.6% of students agreed/strongly agreed that dissection was too time consuming compared to 64.8% on the postsurvey. 82.9% agreed/strongly agreed in the postsurvey that handoffs provided students with more time to study. On the practical exam students performed better on questions covering content when they were on the dissecting‐team 69.4% correct compared to receiver‐team 65.1% (P<0.0001). 61.3% said that handoffs positively affected their overall wellness in the postsurvey (up from 51.1% in the presurvey). 42.0% felt that the handoff process facilitated development of teamwork within their group while 58.0% felt neutral (28.2%) or disagreed (29.8%). 41.4% agreed participating in the handoff process helped them develop handoff skills necessary for patient handoffs while 58.6% were neutral (29.8%) or disagreed (28.7%). Conclusion Students scored significantly lower on exam questions regarding structures they did not dissect, but perceived they had more time to study and felt a positive effect on wellness. Improvements in the handoff procedure are needed to more directly address teamwork and communication skills pertinent to success with future patient handoffs.
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