Medical Education: Medical Student
Medical Education 12: Student 2
Jazmin C. Garcia, DO (she/her/hers)
Pediatric Resident
Rutgers, Robert Wood Johnson Medical School
Paterson, New Jersey, United States
Effective transitions of care is an important skill to providing safe and wholesome patient care by allowing efficient provider to provider communication and decreasing medical error. Given such importance, it was characterized by the Association of American Medical Colleges as one of the Entrustable Professional Activities (EPA 8) medical students should be able to demonstrate to be deemed entrustable at the start of residency.
Use of a validated standardized handoff (IPASS) to evaluate medical students going into a pediatric residency are deemed entrustable to provide effective and efficient patient handoff for transition of care responsibilities.
Evaluation of 4th year medical students at Rutgers-Robert Wood Johnson Medical School accepted into pediatric residencies during the 2022 Medical Student Bootcamp Course. Evaluation of audio files provided by the students delivering handoff to a fellow colleague regarding a critically ill patient. Students were evaluated based on effective use of the IPASS handoff mnemonic (Figure 1) and preceptor evaluation via the modified Chen rubric.
17 medical students accepted into a pediatric residency program provided audio files for evaluation of effective transitions of care. Overall students were able to appropriately use the IPASS mnemonic to provide effective transitions of care: 78% identified the appropriate illness severity, 89% provided appropriate patient summary, 95% presented suitable action list, 74% communicated pertinent situational awareness. (Figure 3) Upon preceptor evaluation, 14/17 students were able to conduct handoff using communication style that decreases the risk of medical error and 76% demonstrated effective IPASS. 47% were able to elicit feedback about handoff. Since there were audio files, written documentation was not able to be adequately evaluated. (Figure 2)
The small sample size places some limitation on the results however overall results indicated that there is a positive correlation with providing educational teaching and allowing learners to practice these skill with their ability to effectively provided patient care handoff to another provider. More emphasizes needs to be placed in feedback and providing situational awareness surrounding patient care. Appropriate transition of care increases provider to provider communication, decreases medical error, and increase patient safety making it an important skill for medical students to hone prior to the start of residency.