title: Simulation-based education with deliberate practice may improve intraoperative handoff skills: a pilot study.
abstract: OBJECTIVE
  To examine the results of simulation-based education with deliberate practice on the acquisition of handoff skills by studying resident intraoperative handoff communication performances.
  
  
  METHODS
  Preinvention and postintervention pilot study.
  
  
  METHODS
  Simulated operating room of a university-affiliated hospital.
  
  
  METHODS
  Resident handoff performances during 27 encounters simulating elective surgery were studied. Ten residents (CA-1, CA-2, and CA-3) participated in a one-day simulation-based handoff course. Each resident repeated simulated handoffs to deliberately practice with an intraoperative handoff checklist. One year later, 7 of the 10 residents participated in simulated intraoperative handoffs. All handoffs were videotaped and later scored for accuracy by trained raters. A handoff assessment tool was used to characterize the type and frequency of communication failures. The percentage of handoff errors and omissions were compared before simulation and postsimulation-based education with deliberate practice and at one year following the course.
  
  
  RESULTS
  Initially, the overall communication failure rate, defined as the percentage of handoff omissions plus errors, was 29.7%. After deliberate practice with the intraoperative handoff checklist, the communication failure rate decreased to 16.8%, and decreased further to 13.2% one year after the course.
  
  
  CONCLUSIONS
  Simulation-based education using deliberate practice may result in improved intraoperative handoff communication and retention of skills at one year.
authors.affiliation: Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA. Electronic address: pukenas@rowan.edu.
authors.forename: Erin W
authors.initials: EW
authors.lastname: Pukenas
authors.affiliation: Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Dodson
authors.affiliation: Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA.
authors.forename: Edward R
authors.initials: ER
authors.lastname: Deal
authors.affiliation: Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA.
authors.forename: Irwin
authors.initials: I
authors.lastname: Gratz
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, Box 0560 UCSF, San Francisco, CA, 94143-0560, USA.
authors.forename: Elaine
authors.initials: E
authors.lastname: Allen
authors.affiliation: Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA.
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Burden
mesh_terms: D000776:Anesthesiology / Q000193:education*; D057189:Checklist; D002983:Clinical Competence; D003142:Communication; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007396:Internship and Residency / Q000592:standards; D007430:Intraoperative Care / Q000379:methods / Q000592:standards*; D009515:New Jersey; D009873:Operating Rooms; D062209:Patient Handoff / Q000592:standards*; D016544:Patient Simulation; D010865:Pilot Projects; D011214:Practice, Psychological
keywords: Anesthesiologists; Deliberate practice; Handoff education; Intraoperative communication; Residency training; Simulation