Department of Midwifery, Faculty of Health and Social care, University of Salford, Greater Manchester, UK.
Med Educ Online. 2013 Jan 11;18:1-5. doi: 10.3402/meo.v18i0.20169.
Much evidence exists to demonstrate that poor handover can directly impact patient safety. There have been calls for formal education on handover, but evidence to guide intervention design and implementation is limited. It is unclear how undergraduate medical schools are tackling this issue and what barrier or facilitators exist to handover education. We set out to determine curriculum objectives, teaching and assessment methods, as well as institutional attitudes towards handover within UK medical schools.
A descriptive, non-experimental, cross-sectional study design was used. A locally developed online questionnaire survey was sent to all UK Medical Schools, after piloting. Descriptive statistics were calculated for closed-ended responses, and free text responses were analysed using a grounded theory approach, with constant comparison taking place through several stages of analysis.
Fifty percent of UK medical schools took part in the study. Nine schools (56%) reported having curriculum outcomes for handover. Significant variations in the teaching and assessments employed were found. Qualitative analysis yielded four key themes: the importance of handover as an education issue, when to educate on handover, the need for further provision of teaching and the need for validated assessment tools to support handover education.
Whilst undergraduate medical schools recognised handover as an important education issue, they do not feel they should have the ultimate responsibility for training in this area and as such are responding in varying ways. Undergraduate medical educators should seek to reach consensus as to the extent of provision they will offer. Weaknesses in the literature regarding how to design such education have exacerbated the problem, but the contemporaneous and growing published evidence base should be employed by educators to address this issue.
大量证据表明,交接不良会直接影响患者安全。人们呼吁对交接进行正式教育,但指导干预设计和实施的证据有限。目前尚不清楚英国的本科医学院校如何解决这个问题,以及交接教育存在哪些障碍或促进因素。我们着手确定英国医学院校的课程目标、教学和评估方法以及机构对交接的态度。
采用描述性、非实验性、横断面研究设计。在试点后,向所有英国医学院校发送了一份本地开发的在线问卷进行调查。对封闭式回答进行了描述性统计,对自由文本回答使用扎根理论方法进行了分析,并在几个分析阶段进行了不断比较。
50%的英国医学院校参与了这项研究。9 所学校(56%)报告了交接方面的课程成果。在教学和评估方面存在显著差异。定性分析产生了四个关键主题:交接作为教育问题的重要性、何时进行交接教育、进一步提供教学的必要性以及支持交接教育的验证评估工具的必要性。
尽管本科医学院校认识到交接是一个重要的教育问题,但他们认为自己不应该承担该领域培训的最终责任,因此以不同的方式做出回应。本科医学教育者应寻求就他们将提供的课程范围达成共识。关于如何设计此类教育的文献中的弱点加剧了这个问题,但当代和不断增长的已发表证据基础应该被教育者用来解决这个问题。