Handover Between Prehospital and Intra-hospital Physicians–Utility of Simulation in Enhancing Quality of Transmission

Abstract

Introduction:

Handover is of big value in preserving continuity of the medical services chain when managing patients. Simulation is well accepted as a good learning method to acquire non-technical skills. Actual studies dealing with this issue are performed on paramedics. Studies involving physicians are rare and usually focus on interviews or questionnaires describing practical situations.

The aim of our study was to evaluate the utility of simulation in enhancing the quality of handover between both pre-hospital and intra-hospital physicians.

Method:

We conducted a prospective pre-test/post-test study in a regional Emergency Medical System (EMS) on the handover topic.

We included voluntary physicians who signed participation consent. The study was designed as a three-step project: theoretical training with pre-test and post-test, 1st simulation session, 2nd simulation session with post-test. The two simulation sessions were evaluated according to a specific score. We evaluated the progression of knowledge (tests means) and skills (percentages of good answers): before and after theoretical training and before and after simulation sessions.

Results:

Sixteen EMS physicians were enrolled. Thirteen were under 40 years old and ten were emergency medicine physician specialists. Theoretical training made progression in means and percentage good answers (post-test 1 vs. pré-test : 9.5±3.3 vs 6.9±2 ; p=0.008 et 22 vs. 10% ; p=0,001 respectively). Progression of means after simulation was noticed (2nd session vs. 1st session) (16.3±0.9 vs. 12.3±2.5 ; p<0.001). Simulation enhanced significant quality of handover. Means and percentage of good answers in tests was better after simulation sessions (post-test 2 vs. post-test 1 vs. pre-test : 10.7±2.8 vs. 9.5±3.3 vs. 6.9±2 ; p=0.01 et 29% vs. 22% vs. 10% ; p<0.001 respectively).

Conclusion:

Our study showed the utility of simulation in enhancing handover between pre-hospital and intra-hospital physicians. Simulation as an active learning method, combined with theoretical training, can improve knowledge and enhance skills.