title: The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance.
abstract: BACKGROUND
  Despite the identification of transfer of patient responsibility as a Core Entrustable Professional Activity for Entering Residency, rigorous methods to evaluate incoming residents' ability to give a verbal handoff of multiple patients are lacking.
  
  
  OBJECTIVE
  Our purpose was to implement a multi-patient, simulation-based curriculum to assess verbal handoff performance.
  
  
  METHODS
  Graduate Medical Education (GME) orientation at an urban, academic medical center.
  
  
  METHODS
  Eighty-four incoming residents from four residency programs participated in the study.
  
  
  METHODS
  The curriculum featured an online training module and a multi-patient observed simulated handoff experience (M-OSHE). Participants verbally "handed off" three mock patients of varying acuity and were evaluated by a trained "receiver" using an expert-informed, five-item checklist.
  
  
  RESULTS
  Prior handoff experience in medical school was associated with higher checklist scores (23% none vs. 33% either third OR fourth year vs. 58% third AND fourth year, p = 0.021). Prior training was associated with prioritization of patients based on acuity (12% no training vs. 38% prior training, p = 0.014). All participants agreed that the M-OSHE realistically portrayed a clinical setting.
  
  
  CONCLUSIONS
  The M-OSHE is a promising strategy for teaching and evaluating entering residents' ability to give verbal handoffs of multiple patients. Prior training and more handoff experience was associated with higher performance, which suggests that additional handoff training in medical school may be of benefit.
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Gaffney
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Farnan
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
authors.forename: Kristen
authors.initials: K
authors.lastname: Hirsch
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: McGinty
authors.affiliation: University of Chicago Pritzker School of Medicine, Chicago, IL, USA. varora@medicine.bsd.uchicago.edu.
authors.forename: Vineet M
authors.initials: VM
authors.lastname: Arora
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004503:Education, Medical, Graduate / Q000379:methods*; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D062209:Patient Handoff
keywords: communication skills; medical education; medical student and residency education
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