M. Gordon is professor of evidence synthesis and systematic review, University of Central Lancashire, Preston, United Kingdom; ORCID: https://orcid.org/0000-0002-1216-5158. E. Hill is senior lecturer, School of Health Sciences, University of Central Lancashire, Preston, United Kingdom; ORCID: http://orcid.org/0000-0003-4984-9446. J.N. Stojan is assistant professor, Department of Internal Medicine and Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan. M. Daniel is assistant dean for curriculum and assistant professor, Department of Emergency Medicine and Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan; ORCID: http://orcid.org/0000-0001-8961-7119.
Acad Med. 2018 Aug;93(8):1234-1244. doi: 10.1097/ACM.0000000000002236.
Effective handovers (handoffs) are vital to patient safety. Medical educators investigated educational interventions to improve handovers in a 2011 systematic review. The number of publications on handover education has increased since then, so authors undertook this updated review.
The authors considered studies involving educational interventions to improve handover amongst undergraduate or postgraduate health professionals in acute care settings. In September 2016, two authors independently conducted a standardized search of online databases and completed a data extraction and quality assessment of the articles included. They conducted a content analysis of and extracted key themes from the interventions described.
Eighteen reports met the inclusion criteria. All but two were based in the United States. Interventions most commonly involved single-patient exercises based on simulation and role-play. Many studies mentioned multiprofessional education or practice, but interventions occurred largely in single-professional contexts. Analysis of interventions revealed three major themes: facilitating information management, reducing the potential for errors, and improving confidence. The majority of studies assessed Kirkpatrick's outcomes of satisfaction and knowledge/skill improvement (Levels 1 and 2). The strength of conclusions was generally weak.
Despite increased interest in and publications on handover, the quality of published research remains poor. Inadequate reporting of interventions, especially as they relate to educational theory, pedagogy, curricula, and resource requirements, continues to impede replication. Weaknesses in methodologies, length of follow-up, and scope of outcomes evaluation (Kirkpatrick levels) persist. Future work to address these issues, and to consider the role of multiprofessional and multiple-patient handovers, is vital.
有效的交接（交接班）对患者安全至关重要。医学教育工作者在 2011 年的系统评价中研究了教育干预措施，以改善交接班。自那时以来，关于交接班教育的出版物数量有所增加，因此作者进行了这项更新的综述。
作者考虑了涉及在急性护理环境中对本科或研究生卫生专业人员进行教育干预以改善交接班的研究。2016 年 9 月，两名作者独立进行了标准化的在线数据库搜索，并对纳入的文章进行了数据提取和质量评估。他们对所描述的干预措施进行了内容分析，并从中提取了关键主题。
有 18 份报告符合纳入标准。除了两份之外，其余的都来自美国。干预措施最常见的是基于模拟和角色扮演的单个患者练习。许多研究提到了多专业教育或实践，但干预措施主要发生在单一专业环境中。对干预措施的分析揭示了三个主要主题：促进信息管理，减少潜在错误，以及增强信心。大多数研究评估了柯克帕特里克的满意度和知识/技能提高的结果（第 1 级和第 2 级）。结论的强度通常较弱。
尽管对接班的兴趣和出版物有所增加，但发表研究的质量仍然很差。干预措施的报告不充分，尤其是与教育理论、教学法、课程和资源需求有关的报告，仍然阻碍了复制。方法学、随访时间和结果评估（柯克帕特里克级别）的范围的局限性仍然存在。未来的工作需要解决这些问题，并考虑多专业和多患者交接班的作用。
