Improving Clinical Teaching Fellow Handover and Induction Preparedness: A Completed Closed-Loop Clinical Audit at...

Clinical teaching fellows (CTFs) provide continuity for undergraduate clinical education, including induction delivery, timetabling coordination, bedside/clinical skills teaching, and day-to-day liaison between students and clinical teams. At Sandwell and West Birmingham Hospitals NHS Trust, West Bromwich, England, the CTF team supports placements for Aston University and the University of Birmingham medical students across Years 3-5 (>150 students), making reliable cohort-to-cohort handover critical.

We conducted a closed-loop clinical audit of CTF handover package usability and perceived operational readiness using an anonymous Google Forms (Google LLC, Mountain View, CA, USA) questionnaire with two Likert-scale items (clarity of the handover document; ease of navigation, scale 1-5), four yes/no process measures (access details current; responsibilities clear; induction information sufficient; digital tools effective), and free-text comments. Baseline data reflected the 2024-2025 cohort's received handover (8^th to 22^nd July 2025; n=6/6). Following a structured improvement package (formal handover presentation; rewritten and reorganised handover document; updated operational access information and signposting), re-audit data were collected from the incoming 2025-2026 cohort (4^th to 10^th August 2025; n=5/7; only five were able to attend the handover meeting due to prior work commitments). This was a local, closed-loop quality improvement clinical audit within a single NHS Trust.

Mean ratings improved from 2.5/5 to 4.6/5 for document clarity and from 2.7/5 to 4.8/5 for ease of navigation. Process measures improved from 33% to 100% for access details, 17% to 100% for role clarity, 0% to 100% for induction sufficiency, and 83% to 100% for digital tool implementation.

A structured handover package was associated with substantial improvement in handover package usability and perceived operational readiness for incoming CTFs. Standardised annual handover (slide deck plus version-controlled document and checklist) is recommended to sustain improvements.