Simulation-based education with deliberate practice may improve intraoperative handoff skills: a pilot study

Abstract

Study objective: To examine the results of simulation-based education with deliberate practice on the acquisition of handoff skills by studying resident intraoperative handoff communication performances.

Design: Preinvention and postintervention pilot study.

Setting: Simulated operating room of a university-affiliated hospital.

Measurements: Resident handoff performances during 27 encounters simulating elective surgery were studied. Ten residents (CA-1, CA-2, and CA-3) participated in a one-day simulation-based handoff course. Each resident repeated simulated handoffs to deliberately practice with an intraoperative handoff checklist. One year later, 7 of the 10 residents participated in simulated intraoperative handoffs. All handoffs were videotaped and later scored for accuracy by trained raters. A handoff assessment tool was used to characterize the type and frequency of communication failures. The percentage of handoff errors and omissions were compared before simulation and postsimulation-based education with deliberate practice and at one year following the course.

Main results: Initially, the overall communication failure rate, defined as the percentage of handoff omissions plus errors, was 29.7%. After deliberate practice with the intraoperative handoff checklist, the communication failure rate decreased to 16.8%, and decreased further to 13.2% one year after the course.

Conclusions: Simulation-based education using deliberate practice may result in improved intraoperative handoff communication and retention of skills at one year.

Keywords: Anesthesiologists; Deliberate practice; Handoff education; Intraoperative communication; Residency training; Simulation.