Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Nashville

Poster Presentation:



Rebecca R. Chasnovitz, MD, MD, Kaiser Oakland  Pediatric Residency Program, Oakland, CA, Abhay Dandekar, MD, Kaiser Oakland  Pediatric Residency Program, Oakland, CA, Margot Brown, MD, UCSF, San  Fransisco, California, Amy Westman, MD, Kaiser Oakland Pediatric Residency  Program, Oakland, California 

Communicating effectively with team members during transitions of care relates directly to an emerging entrustable professional activity (EPA) for learners across the pediatric educational continuum.  However, unlike the H&P and SOAP presentations, hand-over skills are mostly learned “on the fly” rather than taught as a standard part of the medical school curriculum.  Our aims were: 1) to design and implement a curriculum to teach hand-over communication skills to clinical-year medical students through the daily sign-out out of their patients with regular peer and resident feedback, 2) to develop peer feedback skills to enhance lifelong learning and collaborative patient care practices, and 3) to develop a tool that may aid in assessment of the learner's abilities through milestones.  Based on a needs assessment of current third-year medical students at UCSF, we found that most students felt that they had enough experience observing hand-offs, but not enough experience performing hand-offs.  Almost one-third of students surveyed had never performed sign-out on a patient during their first four rotations of third year.  Students expressed interest in receiving feedback on sign-out of their actual patients and very little interest in lecture and role-playing activities as a means of learning hand-over skills.  This curriculum introduces third-year medical students to our program’s standard sign-out format (PSONUT).  Students apply this pneumonic daily by routinely performing sign-out on their patients during team hand-over.  Senior residents provide weekly feedback using a Standardized Clinical Observation form (adapted from Shaughness 2011).  Students rotating on the wards also perform sign-out on their patients to a group of peers, who provide feedback using the same tool.  At the end of the clerkship, we evaluate students’ hand-over communication skills using a hand-off OSCE (Shaughnessy 2011).  This poster will highlight the specific process and tools involved, reflective comments from resident and peer observers, and preliminary data evaluating skills of students who have completed this curriculum.  Finally, this poster will introduce a summative tool that attempts to map feedback back to competency domains and pediatric milestones and cultivate a linkage to entrustment of this activity.