(O-D3) Handoff Simulation: Fake It Until I-PASS It!

Friday, September 8, 2023

10:09 AM - 10:21 AM EEST

Location: Elafos B

Oral Presenter / Primary Author(s)

Amritpal Saini, MD

Resident Physician
Jacobi/Montefiore Emergency Medicine Residency
New York, New York, United States

Co-Author(s)

Nora McNulty, MD

Resident Physician
Montefiore/Jacobi Medical Center
Bronx, New York, United States
NT

Noah Trump, MD

Resident Physician
Jacobi/Montefiore
New York, New York, United States
SD

Sandeep K. Dhillon, MD

Physician
Jacobi Medical Center
Astoria, New York, United States

Faculty Advisor(s)

Maninder Singh, MD

Director of Healthcare Simulation
Jacobi
Bronx, New York, United States
AR

Andrew Restivo, MD

Attending Physician
Montefiore Medical Center
Bronx, New York, United States

Objectives: Using simulation to assess medical student competency of the AAMC Core Entrustable Professional Activity (EPA) 8: giving and receiving a patient handover, using the I-PASS handoff template (sub-competencies ICS2 ICS3 PC8).

Background: EPAs are the standards by which medical students are assessed to determine their readiness for residency and ultimately their eligibility to graduate and become physicians. EPA 8 is one of the communication based competencies and primarily deals with the ability of a medical student to give a patient handover. There is a paucity of studies on how to evaluate medical student competency, especially with regards to EPA 8. This study evaluates the utility of high fidelity simulation as an assessment tool for EPA 8 and as a vehicle to tailor individualized debriefing to improve patient handover.

Methods: 62 fourth-year medical students participated in a simulated case of a medically unstable teenager with a ruptured ectopic pregnancy. Prior to participating in the case, the students were introduced to the I-PASS template in a lecture format. In groups, students participated in the simulated case, each working independently with the patient and then handing-off the patient to their peers. An evaluator observed for performance of critical actions, such as relay of information via the I-PASS handoff tool, maintaining patient privacy and confidentiality (sub-competency P3).

Results: Upon review, when handing off, participants addressed 57.5% of the components I-PASS. After a debrief and simulation, 74.2% of participants felt comfortable using iPASS.

Conclusions: Our experience showed that high fidelity simulation is an effective tool to measure a student's ability to perform patient handoffs within the EPA 8 framework while allowing us to tailor our debrief, in real time, to target areas that are deficient and increase student comfort when using iPASS. This has high relevance to Emergency Medicine residency programs, given that handoffs are a frequent and critical aspect within the field and high quality sign-outs are essential in preserving patient safety and reducing medical errors.

References (Optional):

Funding (Optional): No funding