title: Systematic training in internal medicine-pediatrics end of residency handoffs: residency director attitudes and perceived barriers.
abstract: BACKGROUND
  It is unclear why systematic training in end-of-residency clinic handoffs is not universal.
  
  
  OBJECTIVE
  We assessed Internal Medicine-Pediatrics (Med-Peds) residency program directors' attitudes regarding end-of-residency clinic handoff systems and perceived barriers to their implementation.
  
  
  METHODS
  We surveyed all Med-Peds program directors in the United States about end-of-residency outpatient handoff systems.
  
  
  RESULTS
  Program directors rated systems as important (81.5%), but only 31 programs (46.3%) utilized them. Nearly all programs with (29/31 [93.5%]), and most programs without systems (24/33 [72.7%]) rated them as important. Programs were more likely to have a system if the program director rated it important (p = .049), and less likely if they cited a lack of faculty interest (p = .023) or difficulty identifying residents as primary providers (p = .04).
  
  
  CONCLUSIONS
  Most program directors believe it important to formally hand off outpatients. Barriers to establishing handoff systems can be overcome with modest curricular and cultural changes.
authors.affiliation: a Department of Medicine and Pediatrics, Medstar Georgetown University Hospital , Washington , DC , USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Donnelly
authors.forename: Janelle M
authors.initials: JM
authors.lastname: Clauser
authors.forename: Rochelle E
authors.initials: RE
authors.lastname: Tractenberg
mesh_terms: D002983:Clinical Competence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D008505:Medical Staff, Hospital; D062209:Patient Handoff; D010372:Pediatrics / Q000193:education*; D008486:Physician Executives / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States