A peer-to-peer handoff tool to ease clerkship transitions

Abstract

Educational challenge

Frequent transitions between core clinical rotations in medical school increase anxiety and cognitive load. Few formalized programs exist to ease these transitions. Our institutional needs-assessment found that approximately 85% of students believed that additional rotation-specific information prior to starting a new rotation would reduce anxiety and increase success.

Proposed solution and implementation of solution

We developed a novel web-based peer-to-peer handoff tool available to all clerkship students at a single, large academic institution. The tool contains the names and contact information of students who most recently completed rotations on each service for all clerkships. A handoff checklist was also created with suggested discussion points for handoffs. Students were encouraged to schedule a handoff 1-2 weeks before starting a new rotation.

Lessons learned

Overall, 83 students (66%) utilized the handoff tool, with use and efficacy decreasing with time during the clinical year. Of tool users, 65% expressed that having access to the tool prior to starting a new rotation helped to reduce anxiety, and 74% felt that the information gained helped to ease transitions. Our peer-to-peer handoff tool may help students feel more prepared to start a new rotation, decrease anxiety during clerkship year, and ease transitions.

Next steps

This low-resource intervention may be implemented at other institutions to provide students with equal opportunities to receive valuable information prior to starting new rotations, regardless of pre-existing peer connections. An automated update system, which we are implementing at our institution, could greatly decrease the time required to maintain a handoff tool and improve sustainability.

Keywords:

• Medical student
• transitions
• clerkships
• handoff
• peer-to-peer

Acknowledgements

We would like to thank Dr. C. Jessica Dine for her advice and support with survey design, Dr. Jennifer Kogan for her guidance during manuscript preparation, and Dr. Monique Arnold and Nadir Shah for their technological support for this project.

Disclosure statement

The authors have no conflict of interest to disclose.

Ethics statement

IRB approval at our institution was sought and deemed exempt. All participants were provided a consent statement via email for voluntary participation in the need-assessment survey, evaluation survey, and publication of results. All data were collected anonymously.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Claire E. Fishman

Claire E. Fishman, MD, is a PGY1 Internal Medicine resident at the Hospital of the University of Pennsylvania.

Thomas Sommers

Thomas Sommers, MD, is a PGY2 Internal Medicine resident at Massachusetts General Hospital.

Nadia L. Bennett

Nadia L. Bennett, MD, MSEd, is a professor of clinical medicine in the Division of Hospital Medicine at the University of Pennsylvania Perelman School of Medicine. She is the Associate Dean of UME Clinical and Health Systems Sciences Curriculum.

Margot E. Cohen

Margot E. Cohen, MD, MSEd, is an assistant professor of clinical medicine in the Division of Hospital Medicine at the University of Pennsylvania Perelman School of Medicine. She is the co-director of the Internal Medicine core clerkship.