Faculty member review and feedback using a sign-out checklist:  improving intern written sign-out.
OBJECTIVE
Although residents commonly perform patient care sign-out during training, faculty do not frequently supervise or evaluate sign-out. The authors designed a sign-out checklist, and they investigated whether use of the checklist, paired with faculty member review and feedback, would improve interns' written sign-out.


METHODS
In a randomized, controlled design in 2011, the authors compared the sign-out content and the overall sign-out summary scores of interns who received twice-monthly faculty member sign-out evaluation with those of interns who received the standard sign-out instruction. A sign-out checklist, which the authors developed on the basis of internal needs assessment and published sign-out recommendations, guided the evaluation of written sign-out content and sign-out organization as well as the twice-monthly, face-to-face evaluation that the interns in the intervention group received.


RESULTS
Using the sign-out checklist and receiving feedback from a faculty member led to statistically significant improvements in interns' sign-out. Through regression analysis, the authors calculated a 23% difference in the sign-out content (P = .005) and a 2.2-point difference in the overall summary score (on a 9-point scale, P = .009) between the interns who received sign-out feedback and those who did not. The content and quality of the intervention group's sign-outs improved, whereas the content and quality of the control group's worsened.


CONCLUSIONS
A sign-out checklist paired with twice-monthly, face-to-face feedback from a faculty member led to improvements in the content and quality of interns' written sign-out.
Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213-2582, USA. bumpgm@upmc.edu
Gregory M
GM
Bump
James E
JE
Bost
Raquel
R
Buranosky
Michael
M
Elnicki
D057189:Checklist; D002983:Clinical Competence; D003142:Communication; D003266:Continuity of Patient Care; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000592:standards; D004521:Educational Measurement; D005180:Faculty, Medical; D005246:Feedback; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000592:standards*; D008297:Male; D011787:Quality of Health Care; D012044:Regression Analysis; D012308:Risk Management; D017751:Safety Management; D014956:Writing