Effect of Handoff Training on Resident Communication Quality: An Observational Study

Abstract

We evaluated the effect of handoff training conducted during resident orientation on communication quality using a non-randomized between-subjects study, where the training group received structured, in-person handoff training, and the control group received no training. Handoff conversations for both groups were audio-recorded. Communication quality was measured as the frequency of communication breakdowns. We found that training group had fewer breakdowns; however, after adjusting for patient acuity and patient days in the unit, communication quality between the two groups were similar (OR=0.3, 95% CI=0.08-1.07, p=0.06). However, there were significant differences in the clinical content exchanged during communication: compared to the control group, residents in the training group discussed significantly more clinical content related to identifying information, past medical history and contextual information; and less clinical content related to active problems and assessment of active problems. We discuss the implications of such handoff training program during resident orientations.