The usefulness and feasibility of a reflexivity method to improve clinical handover

The evaluation of the usefulness and feasibility of the reflexivity method (RM), which encourages dialogue and reflections between doctors, and enables change.

On the basis of literature research into effective medical professional learning and reflection, essential elements that stimulate reflection and learning were distinguished and converted into the basic elements of a method developed for this purpose, the RM. The method is used as a tool to stimulate reflection processes, which, in turn, will enable change. It was used 20 times in a large university medical centre in the Netherlands. Clinical handovers were the subject of reflection. The evaluation of the usefulness and feasibility of the RM is based on analysing the improvements realized by using the method, and a questionnaire to measure the experiences of the users of the method.

Each of the 17 departments evaluated received 10 recommendations on average. Fifty-eight per cent of these were realized after 6-9 months, and 18% were in the working-out phase. Improvements in the structure, rules and protocols concerning handovers were realized as well as in the atmosphere. The users of the method evaluated the method overall positively: they appreciated the created context for reflection, that is, having a dialogue with a colleague working at the same hierarchical level, the non-normative character of the method and the 'doctor-ownership' of the method. They also reported an effect on their handling and thinking regarding handovers.

The RM seems to be a useful and feasible method to stimulate the doctors' reflection processes, resulting in implemented improvements.