Acad Med. 2020 Nov 10. doi: 10.1097/ACM.0000000000003842. Online ahead of print.
PURPOSE: Learner handover is the sharing of information about learners between faculty supervisors. Learner handover can support longitudinal assessment in rotation-based systems, but there are concerns that the practice could bias future assessments or stigmatize struggling learners. Because successful implementation relies on an understanding of existing practices and beliefs, the purpose of this study was to explore how faculty perceive and enact learner handover in the workplace.
METHOD: Using constructivist grounded theory, 23 semistructured interviews were conducted with faculty from 2 Canadian universities between August and December 2018. Participants were asked to describe their learner handover practices, including learner handover delivered or received about resident and student trainees either within or between clinical rotations. The authors probed to understand why faculty used learner handover and their perceptions of its benefits and risks.
RESULTS: Learner handover occurs both formally and informally and serves multiple purposes for learners and faculty. While participants reported that learner handover was motivated by both learner benefit and patient safety, they primarily described motivations focused on their own needs. Learner handover was used to improve faculty efficiency by focusing teaching and feedback and was perceived as a "self-defense mechanism" when faculty were uncertain about a learner's competence and trustworthiness. Informal learner handover also served social or therapeutic purposes when faculty used these conversations to gossip, vent, or manage insecurities about their assessment of learner performance. Because of its multiple, sometimes unsanctioned purposes, participants recommended being reflective about motivations behind learner handover conversations.
CONCLUSIONS: Learners are not the only potential beneficiaries of learner handover; faculty use learner handover to lessen insecurities surrounding entrustment and assessment of learners and to openly share their frustrations. The latter created tensions for faculty needing to share stresses but wanting to act professionally. Formal education policies regarding learner handover should consider faculty perspectives.
PMID:33177320 | DOI:10.1097/ACM.0000000000003842