Section of Hospital Medicine, Department of Medicine, The University of Chicago, 5841 South Maryland Ave., MC 2007, Chicago, IL 60637, USA.
J Gen Intern Med. 2010 Feb;25(2):129-34. doi: 10.1007/s11606-009-1170-y.
The Observed Simulated Hand-off Experience (OSHE) was created to evaluate medical students' sign-out skills using a real-time assessment tool, the Hand-off CEX.
Thirty-two 4th year medical students participated as part of an elective course.
One week following an interactive workshop where students learned effective hand-off strategies, students participated in an experience in which they performed a hand-off of a mock patient using simulated history and physical examination data and a brief video.
Internal medicine residents served as standardized hand-off receivers and were trained on expectations. Students were provided feedback using a newly developed Hand-off CEX, based on the "Mini-CEX," which rates overall hand-off performance and its components on a 9-point Likert-type scale. Outcomes included performance ratings and pre- and post-student self-assessments of hand-off preparedness. Data were analyzed using Wilcoxon signed-rank tests and descriptive statistics. Resident receivers rated overall student performance with a mean score of 6.75 (range 4-9, maximum 9). Statistically significant improvement was observed in self-perceived preparedness for performing an effective hand-off (67% post- vs. 27% pre-reporting 'well-prepared,' p<0.009).
This brief, standardized hand-off training exercise improved students' confidence and was rated highly by trained observers. Future work focuses on formal validation of the Hand-off CEX instrument.
The online version of this article (doi:10.1007/s11606-009-1170-y) contains supplementary material, which is available to authorized users.
观察模拟交班体验（OSHE）是为了使用实时评估工具交接 CEX 来评估医学生的交班技能而创建的。
32 名四年级医学生作为选修课程的一部分参与了该项目。
在互动研讨会之后的一周，学生学习了有效的交班策略，然后他们在体验中模拟病史和体检数据以及简短的视频，进行了模拟患者的交班。
内科住院医师作为标准化的交班接收者，并接受了预期的培训。学生使用新开发的交接 CEX 反馈，该 CEX 基于“迷你 CEX”，以 9 点李克特量表评估整体交班表现及其组成部分。结果包括表现评分和交班准备的学生自我评估。使用 Wilcoxon 符号秩检验和描述性统计分析数据。住院医师接收者对整体学生表现的评分平均为 6.75（范围 4-9，最高 9）。观察到自我感知的有效交班准备程度显著提高（67%的学生在交班后报告“准备充分”，而 27%的学生在交班前报告“准备充分”，p<0.009）。
这个简短的标准化交班培训练习提高了学生的信心，并且受到了经过培训的观察者的高度评价。未来的工作重点是对接班 CEX 仪器进行正式验证。
本文的在线版本（doi:10.1007/s11606-009-1170-y）包含补充材料，可供授权用户使用。
