title: Pediatric residency program handover: before and after the ACGME requirement.
abstract: OBJECTIVE
  To determine what changes occurred in pediatric residency programs with regards to handover education and assessment before and after the Accreditation Council for Graduate Medical Education (ACGME) requirement mandating monitoring safe handover practices in July 2011.
  
  
  METHODS
  We sent surveys at 2 time periods to all pediatric program directors in the United States, as identified from a list provided by the Association of Pediatric Program Directors. Respondents were asked about their program demographics, whether they had handover curricula, how trainees were taught to perform handovers, and perceived barriers to effective handover.
  
  
  RESULTS
  Response rates were 58% in both survey years. After the ACGME requirement, only 1 of 3 of programs reported a handover curriculum with goals, objectives, and assessment tools. There was a statistically significant increase in the percentage of those responding that resident handover education primarily occurred by role modeling (66% vs 82%; P < .05). Other learners (visiting residents, medical students) also continued to learn handover skills by role modeling (55% vs 56%; P = NS). Lack of feedback and interruptions were recognized as barriers to successful handover by program directors in both survey years.
  
  
  CONCLUSIONS
  There is a continued need for handover curricula with didactic and practical components as well as assessment pieces within pediatric residency programs. Barriers to effective handover such as lack of feedback and interruptions continue to be major problems. There is a lack of faculty ownership and interest in learner handover that may affect long-term successes. Because role modeling continues to be the main way in which trainees learn handover, specific attention should be given to teach role-modeling techniques.
authors.affiliation: Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, Conn. Electronic address: mheld@connecticutchildrens.org.
authors.forename: Melissa R
authors.initials: MR
authors.lastname: Held
authors.affiliation: Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, Conn.
authors.forename: Georgine S
authors.initials: GS
authors.lastname: Burke
authors.affiliation: Department of Pediatrics, Connecticut Children's Medical Center, University of Connecticut School of Medicine, Hartford, Conn.
authors.forename: Edwin
authors.initials: E
authors.lastname: Zalneraitis
mesh_terms: D000068:Accreditation; D003479:Curriculum / Q000592:standards*; D003710:Demography; D004503:Education, Medical, Graduate / Q000639:trends*; D004521:Educational Measurement; D006801:Humans; D007396:Internship and Residency; D010372:Pediatrics / Q000193:education*; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D014481:United States
keywords: graduate medical education; handover; pediatrics; residency; role modeling