Does learner handover bias ratings, entrustment decisions, and feedback across repeated encounters with the same...

Learner Handover (LH) involves sharing information about learners between faculty supervisors, aligning with a growth mindset. Previous studies, however, demonstrate LH can bias subsequent ratings. Most of these studies collect ratings after a single encounter but faculty often have multiple interactions with learners potentially mitigating LH-related bias. This study explored if LH influences faculty ratings, entrustment decisions and feedback after observing several encounters of the same learner. Internal medicine faculty (n = 57) from five medical schools were randomly assigned to one of three study groups. Each group received either positive, negative or no LH prior to watching five simulated resident-patient encounter videos of the same white male resident. Participants rated each video using an entrustment scale, the Mini-CEX and provided written feedback. Feedback was assigned a valence score (-3 to + 3). There were no statistically significant differences between the mean ratings across the LH conditions (positive, control, negative) for entrustment [3.42, 3.26, 3.62], Mini-CEX [6.00, 5.90, 6.28] or feedback valence ratings [-0.34, -0.99, -0.74]. In the post-study questionnaire, most raters reported the LH had minimal effect on their decisions. Only 29% of raters guessed the true purpose of the study. Unlike previous studies, LH had no effect on ratings, entrustment decisions, or feedback after one encounter, nor over subsequent encounters with the same resident. These findings suggest LH's influence may vary and highlight the need for replication under different conditions, including diverse genders and equity-deserving groups, to identify factors that contribute to or mitigate bias.