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A Responsible Educational Handover: Improving Communication to Improve Learning
Helen K Morgan1, George C Mejicano, Susan Skochelak
1H.K. Morgan is clinical associate professor of obstetrics and gynecology and learning health sciences, University of Michigan Medical School, Ann Arbor, Michigan. G.C. Mejicano is senior associate dean for education and professor of medicine, Oregon Health & Science University, Portland, Oregon. S. Skochelak is group vice president, Medical Education, American Medical Association, Chicago, Illinois. K. Lomis is vice president of undergraduate medical education innovations, American Medical Association, Chicago, Illinois. R. Hawkins is president and CEO, American Board of Medical Specialties, Chicago, Illinois. A.R. Tunkel is senior associate dean for medical education and professor of medicine and medical science, Warren Alpert Medical School of Brown University, Providence, Rhode Island. E.A. Nelson is associate dean of undergraduate medical education and distinguished teaching professor, Dell Medical School, University of Texas at Austin, Austin, Texas. D. Henderson is associate dean for student affairs, associate dean for multicultural and community affairs, and associate professor of family medicine, University of Connecticut School of Medicine, Farmington, Connecticut. A.V. Shelgikar is clinical associate professor of neurology, University of Michigan Medical School, Ann Arbor, Michigan. S.A. Santen is senior associate dean of assessment, evaluation, and scholarship and professor of emergency medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Abstract:
An important tenet of competency-based medical education is that the educational continuum should be seamless. The transition from undergraduate medical education (UME) to graduate medical education (GME) is far from seamless, however. Current practices around this transition drive students to focus on appearing to be competitively prepared for residency. A communication at the completion of UME-an educational handover-would encourage students to focus on actually preparing for the care of patients. In April 2018, the American Medical Association's Accelerating Change in Medical Education consortium meeting included a debate and discussion on providing learner performance measures as part of a responsible educational handover from UME to GME. In this Perspective, the authors describe the resulting 5 recommendations for developing such a handover: (1) The purpose of the educational handover should be to provide medical school performance data to guide continued improvement in learner ability and performance, (2) the process used to create an educational handover should be philosophically and practically aligned with the learner's continuous quality improvement, (3) the educational handover should be learner driven with a focus on individualized learning plans that are coproduced by the learner and a coach or advisor, (4) the transfer of information within an educational handover should be done in a standardized format, and (5) together, medical schools and residency programs must invest in adequate infrastructure to support learner improvement. These recommendations are shared to encourage implementation of the educational handover and to generate a potential research agenda that can inform policy and best practices.
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