The e-handover: applications for surgical training

Abstract

Background: Workplace-based assessments introduced in part to compensate for the reduced 'hands on' experience of surgical trainees are now a compulsory facet of surgical training. Taking the form of 'tick box' exercises they largely focus on procedural competence. This work aimed to ascertain whether a standardised electronic handover could also be used as a surrogate marker of trainees' diagnostic skills.

Methods: All data inputted by surgical trainees 'on call' were collected prospectively and saved in an encrypted database within the Department of Surgery. Presumptive diagnoses made by the admitting trainee over a 2-year time period were then compared with the discharge diagnosis as recorded on the hospital's computer system.

Results: Seventeen surgical trainees were analysed over the study time period, with 936 patients requiring in-patient admission suitable for inclusion. An improvement in trainees' diagnostic accuracy was noted over a 6-month period (p = 0.047). Further subgroup analysis demonstrated increased accuracy amongst trainees with general surgical posts as opposed to urology trainees (p = 0.046), and increased accuracy with increased workload (p = 0.042).

Conclusion: The e-handover has real potential as an adjunct to established assessment tools currently in use and may provide the stimulus for valuable feedback to trainees. [Can a] standardised e-handover also be used as a surrogate marker of trainees' diagnostic skills?