Deliberate practice of nurse handoff using simulation: A multi-site study

Determine the effectiveness of deliberate practice on improving handoff communication accuracy among prelicensure nursing students.

Ineffective handoff contributes to preventable and costly medical errors, incorrect or delayed diagnosis and treatment and increased costs. Deliberate practice is recommended for skill development; however, little is known about the effectiveness of this teaching method with handoff.

A one-group repeated measures quasi-experimental design was used.

A convenience sample of prelicensure nursing students were recruited from four United States schools of nursing. Using simulation, participants independently completed four handoffs over three study visits, spaced three to four weeks apart. Each visit included deliberate practice of handoff communication to an incoming simulated participant nurse. Observational data on handoff accuracy were collected using the I-SBAR (Identification, Situation, Background, Assessment, Recommendation) tool. Total scores on the I-SBAR range from 0 to 10. Change in handoff scores over time were analyzed via a linear mixed-effects model. Covariates of age, grade point average, study site and healthcare work experience were investigated.

Fifty-one students participated in the study. Mean handoff scores increased from 6.24 at T0 (baseline) to 8.34 at T1, declined to 6.96 at T2 and increased to 7.82 at T3 (final assessment). Statistically significant (p < 0.001) improvement was observed from baseline to final assessment.

Findings support the deliberate practice method of handoff communication skills for increasing handoff accuracy in nursing students. Future research should consider skill decay and need for continued deliberate practice of handoff skills.