Mitigating “Educational Groundhog Day” – The Role of Learner Handoffs Within Clinical Rotations: A Survey of Pediatric Educational Leaders

Fuchs, Jennifer; King, Marta; Devon, Erin Pete; Guffey, Danielle; Keeley, Meg; Rocha, Mary Esther M.

doi:10.1016/j.acap.2019.08.011

Cited by 6 publications

(23 citation statements)

References 24 publications

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“…Additionally, less than one-third of our respondents reported that LHs were a formal expectation of their group of faculty. Despite sampling pediatric educators, who have likely received more faculty development than their non-educator colleagues, a minority reported using a structured format for their LHs, with even fewer having received any form (Fuchs et al, 2020), our results further suggest that few individuals or faculty groups currently employ a structured or coordinated method for learner handovers.…”

Section: Discussionmentioning

confidence: 64%

“…Previous studies have shown increasing interest in LHs as a means to improve learner education (Fuchs et al, 2020;Babbott, 2010). However, there is still little known about their utilization and perceived effectiveness in practice.…”

Section: Discussionmentioning

confidence: 99%

“…The authors, three of whom have extensive educational and pediatric inpatient medicine experience, drafted a survey including multiple-choice, Likert-scale, and free-text questions focusing on experiences/practices and attitudes towards LHs, along with baseline demographic data (Supplementary File 1: Learner Handoff Survey). The survey instrument was developed based on literature review, including a recent survey on medical student educational handoffs (Fuchs et al, 2020). The items were then developed through an iterative process among the authors and piloted via cognitive interviews with four pediatric educators at two institutions prior to inclusion in the final survey.…”

Section: Survey Developmentmentioning

confidence: 99%

“…Entrustment, or the ability of the learner to complete specific "units of professional practice" without supervision (Englander and Carraccio, 2014;Cleary, 2008), is developed incrementally over time through deliberate faculty observations (Sterkenburg et al, 2010). However, with reports that inpatient attendings supervise for 5-7 days on average, and that it takes 5 or more days to determine initial entrustment (Fuchs et al, 2020), trainees may get stuck in a cycle of entrustment and non-entrustment if there is no communication between supervisor transitions.…”

Section: Introductionmentioning

confidence: 99%

“…Given the frequency of inpatient faculty supervisor transitions, pediatric hospitalists frequently must decide whether and how to handover learners to the oncoming supervisor. However, little is known about the utilization and variability of LHs (Fuchs et al, 2020;Babbott, 2010;Warm et al, 2017;Gumuchian et al, 2020). With pediatric hospitalists' frontline role in pediatric education (Freed, Dunham and Lamarand, 2009;Fromme et al, 2010;Ottolini, 2014), our primary goal was to determine their experiences with and attitudes toward current LH practices during supervisory transitions.…”

Section: Introductionmentioning

confidence: 99%

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Learner handoffs: Attitudes and practices of pediatric hospitalist educators

Fishman¹,

Marcus²,

Winn³

et al. 2021

MedEdPublish

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Introduction: Communication failures during frequent transitions in attending supervision can lead to delayed entrustment, uncoordinated feedback, and arrested professional development for trainees. With structured patient handoffs showing promise in patient outcomes, attention has been paid to learner handoffs (LHs), though little is known about their utilization and effectiveness. The aim of this study was to identify attitudes and practices of pediatric hospitalist educators towards LHs.Methods: An anonymous electronic survey was distributed to members of the American Academy of Pediatrics (AAP) Pediatric Hospital Medicine Educator Listserv. Data was analyzed using mixed-methods.Results: Of 584 eligible educators, 129 (22%) responded. Most respondents (78%) were familiar with LHs, though only 30% reported that they were an expectation of their pediatric hospitalist groups. Only 15% reported using a structured format, and only 10% of educators received any formal training. A handoff of each additional learner was reported to add less than 5 minutes to the overall handoff. The vast majority reported LHs improved their ability to give accurate feedback (93%) and to tailor teaching (89%), while almost half (46%) reported LHs improved patient care. Major qualitative themes for advantages of LHs included better understanding learner capabilities, learner goals/attending expectations, and optimizing feedback. Barriers to implementation included time constraints and potential for bias.Discussion: Despite overwhelmingly positive views regarding teaching and feedback, LHs often remain unstructured, unexpected, and delivered by untrained supervisors. The development of a structured LH tool, in conjunction with faculty buy-in and training, may accelerate trainee professional development, while mitigating any concerns for added bias.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Survey Developmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Learner handoffs: Attitudes and practices of pediatric hospitalist educators

Fishman¹,

Marcus²,

Winn³

et al. 2021

MedEdPublish

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Learner Handoffs Within Clinical Rotations: From the Resident Perspective

et al. 2022

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PurposeCompetency-based medical education relies on repeated longitudinal assessments of learners. Frequent attending physician transitions within clinical rotations present a significant barrier to the educational continuity required in competency-based medical education. Learner handoffs (LHs), or the transfer of information regarding learners on a team among faculty supervisors, is a potential solution. Although literature is available on educational leader and clinical faculty perspectives on LHs, perspectives of the learners have been less well described. MethodThis qualitative study used thematic analysis of pediatric resident focus groups from 3 programs of varying size and geographic location from July to December 2021. Two authors independently read the first 3 transcripts to generate a codebook and then coded the remaining transcripts independently to ensure thematic saturation. Emerging themes were discussed and revised until a consensus was achieved.

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The missing ingredient: Medical student insights to inform and enhance learner handover

Conway,

McKeague,

Harney

2023

The Clinical Teacher

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BackgroundLearner handover (LH) is the passing on of information about students between educators. In light of broad acceptance that LH can improve learner support experiences and performance outcomes, those involved are seeking greater governance to achieve practical, effective handover implementation. Stakeholder consultation can inform and enable the co‐creation of meaningful, robust practice guidance. This study sought to address the gap in literature around in‐depth learner opinion, a key element so far overlooked.MethodsThis qualitative study (2022) investigated undergraduate medical student perspectives on appropriate tutor information‐sharing at the University of Limerick School of Medicine (ULSoM). The findings build upon an educator focus group study published by the authors (2021). Eleven participants were recruited to represent the typical graduate‐entry medical school programme population across years 1–4 of study. Their understanding and expectations of “learner handover” were explored qualitatively, using online, individual, semi‐structured interviews. Inductive transcript coding and thematic data analysis were applied to illustrate learner insights.FindingsEmergent themes included shared values, individual context and collaborative process, with ideas proposed for specific action around student education, staff training, mental health support, and documented procedures.DiscussionConsent, system transparency, data security and the development of positive handover culture were revealed as current needs. Student perspectives, together existing LH literature and highlighted aspects of educational theory, allowed the creation a new conceptual LH framework as a foundation for practice improvement.ConclusionThese findings provide clarity and contextual understanding, mainly from a pre‐clinical phase learner standpoint, with pragmatic suggestions to enhance LH appeal.

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Mitigating “Educational Groundhog Day” – The Role of Learner Handoffs Within Clinical Rotations: A Survey of Pediatric Educational Leaders

Cited by 6 publications

References 24 publications

Learner handoffs: Attitudes and practices of pediatric hospitalist educators

Learner handoffs: Attitudes and practices of pediatric hospitalist educators

Learner Handoffs Within Clinical Rotations: From the Resident Perspective

The missing ingredient: Medical student insights to inform and enhance learner handover

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