TY - JOUR
T1 - Mitigating “Educational Groundhog Day” – The Role of Learner Handoffs Within Clinical Rotations
T2 - A Survey of Pediatric Educational Leaders
AU - Fuchs, Jennifer
AU - King, Marta
AU - Devon, Erin Pete
AU - Guffey, Danielle
AU - Keeley, Meg
AU - Rocha, Mary Esther M.
N1 - Publisher Copyright:
© 2019 Academic Pediatric Association
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Medical students decry frequent changes in faculty supervision, leading to the experience of “educational groundhog day.” The discontinuity in supervision, cursory relationships, and uncoordinated feedback impede students’ skill acquisition and delay entrustment decisions. Whereas patient handoff bundles are common, little is known about similarly structured approaches to learner handoffs (LHs). Objective: To describe current LH procedures and practices within pediatric clerkships and subinternships and to gauge interest in a future LH bundle. Methods: Nine items included in the 2016 Council on Medical Student Education in Pediatrics annual member survey were analyzed using mixed-methods. Results: The response rates were 66% (101 of 152) and 40% (165 of 411) for institutions and individuals, respectively. After limiting data to complete responses to programs with traditional block rotations, 54% of individual respondents (76 of 141) identified as inpatient faculty and about a quarter endorsed providing LHs. Inpatient faculty most commonly supervise medical students for 5 to 7 days. Most endorsed needing 1 to 3 days to determine a student's baseline performance and 5 days or more to make entrustment decisions. Three-quarters of inpatient faculty endorsed interest in LHs, while fewer than 16% of course directors currently provide LH expectations. Four themes emerged: instrument features, stakeholder buy-in, impact, and utility. Conclusions: Typical inpatient faculty service days approximate the time required for making entrustment decisions about clinical students. While most inpatient faculty desire a LH bundle for use within a clinical rotation, few institutions and faculty currently use LHs. LHs could accelerate entrustment decisions by allowing coordinated feedback that might hasten learner clinical-skill development.
AB - Background: Medical students decry frequent changes in faculty supervision, leading to the experience of “educational groundhog day.” The discontinuity in supervision, cursory relationships, and uncoordinated feedback impede students’ skill acquisition and delay entrustment decisions. Whereas patient handoff bundles are common, little is known about similarly structured approaches to learner handoffs (LHs). Objective: To describe current LH procedures and practices within pediatric clerkships and subinternships and to gauge interest in a future LH bundle. Methods: Nine items included in the 2016 Council on Medical Student Education in Pediatrics annual member survey were analyzed using mixed-methods. Results: The response rates were 66% (101 of 152) and 40% (165 of 411) for institutions and individuals, respectively. After limiting data to complete responses to programs with traditional block rotations, 54% of individual respondents (76 of 141) identified as inpatient faculty and about a quarter endorsed providing LHs. Inpatient faculty most commonly supervise medical students for 5 to 7 days. Most endorsed needing 1 to 3 days to determine a student's baseline performance and 5 days or more to make entrustment decisions. Three-quarters of inpatient faculty endorsed interest in LHs, while fewer than 16% of course directors currently provide LH expectations. Four themes emerged: instrument features, stakeholder buy-in, impact, and utility. Conclusions: Typical inpatient faculty service days approximate the time required for making entrustment decisions about clinical students. While most inpatient faculty desire a LH bundle for use within a clinical rotation, few institutions and faculty currently use LHs. LHs could accelerate entrustment decisions by allowing coordinated feedback that might hasten learner clinical-skill development.
KW - educational groundhog day
KW - educational handoff
KW - entrustable professional activity
KW - entrustment
KW - learner handoff
KW - medical education
UR - http://www.scopus.com/inward/record.url?scp=85073068677&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85073068677&partnerID=8YFLogxK
U2 - 10.1016/j.acap.2019.08.011
DO - 10.1016/j.acap.2019.08.011
M3 - Article
C2 - 31445968
AN - SCOPUS:85073068677
SN - 1876-2859
VL - 20
SP - 113
EP - 118
JO - Academic Pediatrics
JF - Academic Pediatrics
IS - 1
ER -