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

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.