The e-handover: applications for surgical training

Workplace-based assessments introduced in part to compensate for the reduced 'hands on' experience of surgical trainees are now a compulsory facet of surgical training. Taking the form of 'tick box' exercises they largely focus on procedural competence. This work aimed to ascertain whether a standardised electronic handover could also be used as a surrogate marker of trainees' diagnostic skills.

All data inputted by surgical trainees 'on call' were collected prospectively and saved in an encrypted database within the Department of Surgery. Presumptive diagnoses made by the admitting trainee over a 2-year time period were then compared with the discharge diagnosis as recorded on the hospital's computer system.

Seventeen surgical trainees were analysed over the study time period, with 936 patients requiring in-patient admission suitable for inclusion. An improvement in trainees' diagnostic accuracy was noted over a 6-month period (p = 0.047). Further subgroup analysis demonstrated increased accuracy amongst trainees with general surgical posts as opposed to urology trainees (p = 0.046), and increased accuracy with increased workload (p = 0.042).

The e-handover has real potential as an adjunct to established assessment tools currently in use and may provide the stimulus for valuable feedback to trainees. [Can a] standardised e-handover also be used as a surrogate marker of trainees' diagnostic skills?