Development and implementation of an oral sign-out skills curriculum.
BACKGROUND
Imperfect sign-out of patient information between providers has been shown to contribute to medical error, but there are no standardized curricula to teach sign-out skills. At our institution, we identified several deficiencies in skills and a lack of any existing training.


OBJECTIVE
To develop a sign-out curriculum for medical house staff.


METHODS
Internal medicine residency program.


METHODS
We developed a 1-h curriculum and implemented it in August of 2006 at three hospital sites. Teaching strategies included facilitated discussion, modeling, and observed individual practice with feedback. We emphasized interactive communication, a structured sign-out format summarized by an easy-to-remember mnemonic ("SIGNOUT"), consistent inclusion of key content items such as anticipatory guidance, and use of concrete language.


RESULTS
We received 34 evaluations. The mean score for the course was 4.44 +/- 0.61 on a 1-5 scale. Perceived usefulness of the structured oral communication format was 4.46 +/- 0.78. Participants rated their comfort with providing oral sign-out significantly higher after the session than before (3.27 +/- 1.0 before vs. 3.94 +/- 0.90 after; p < .001).


CONCLUSIONS
We developed an oral sign-out curriculum that was brief, structured, and well received by participants. Further study is necessary to determine the long-term impact of the curriculum.
Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, USA. leora.horwitz@yale.edu
Leora I
LI
Horwitz
Tannaz
T
Moin
Michael L
ML
Green
D000328:Adult; D003142:Communication; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D007400:Interprofessional Relations; D008297:Male; D010817:Physician-Patient Relations; D012680:Sensitivity and Specificity; D017749:Total Quality Management