Mitigating “Educational Groundhog Day” – The Role of Learner Handoffs Within Clinical Rotations: A Survey of Pediatric Educational Leaders

Jennifer Fuchs, Marta King, Erin Pete Devon, Danielle Guffey, Meg Keeley, Mary Esther M. Rocha

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)113-118
Number of pages6
JournalAcademic Pediatrics
Volume20
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • educational groundhog day
  • educational handoff
  • entrustable professional activity
  • entrustment
  • learner handoff
  • medical education

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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