Hand-off education and evaluation: piloting the observed simulated hand-off experience (OSHE).

Area of Science:

• Medical Education
• Clinical Skills Assessment
• Patient Safety

Background:

• Effective patient hand-offs are crucial for patient safety and continuity of care.
• Medical students require structured training and assessment to develop proficiency in clinical sign-outs.
• Existing assessment tools may not adequately capture the nuances of real-time hand-off performance.

Purpose of the Study:

• To evaluate the effectiveness of the Observed Simulated Hand-off Experience (OSHE) in assessing medical students' sign-out skills.
• To introduce and utilize a novel assessment tool, the Hand-off Clinical Evaluation Exercise (CEX), for real-time evaluation.
• To measure improvements in medical students' self-perceived preparedness for performing patient hand-offs.

Main Methods:

• Fourth-year medical students participated in a simulated hand-off scenario after an interactive workshop on effective strategies.
• Students performed a mock patient hand-off using simulated data and a video, observed by trained internal medicine residents.
• The Hand-off CEX, a 9-point Likert scale tool based on the Mini-CEX, was used for feedback and performance rating.

Main Results:

• Resident observers rated overall student hand-off performance with a mean score of 6.75 out of 9.
• A statistically significant increase in self-reported preparedness was observed, with 67% of students feeling 'well-prepared' post-exercise compared to 27% pre-exercise (p<0.009).
• The OSHE and Hand-off CEX provided valuable feedback for skill development.

Conclusions:

• The brief, standardized hand-off training exercise effectively improved medical students' confidence and preparedness.
• The Hand-off CEX was rated highly by trained observers, indicating its utility as an assessment instrument.
• Further validation of the Hand-off CEX is planned to establish its formal psychometric properties.