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Table 2 Training and experience themes, experiential learning skills and representative quotes related to end-of-shift handoffs

From: Content counts, but context makes the difference in developing expertise: a qualitative study of how residents learn end of shift handoffs



Representative quote(s)

Acquire and apply knowledge to anticipate patient needs and tasks

Apply newly acquired clinical knowledge

“When you become an intern and now you’re in a residency, you learn a lot more about what’s important because your knowledge is growing as a doctor.”

Provide anticipatory guidance and assign tasks

“…Giving them recommendations based on potential scenarios…”

“I think now that as I got more experience, I am able to anticipate what problems I see might happen with a patient a little bit better. So, if I foresee that something would go wrong with a patient, I like to tell the cross-cover person you know like ‘Hey, watch out for this guy to go into alcohol withdrawal and if he does, do this.’”

Align information needs to work tasks (content and amount)

Identify pertinent information

“What’s important for someone who’s going to take care of this patient for 14 h needs to know…”

“I think it just takes a lot of practice and being on both ends, like receiving and providing to kind of see where the benefits of providing certain pieces of information are, so I think everybody just kind of has to experience it…”

Be concise

“…Concise is important because there are things. There is a lot. Time doesn’t stand still for handoffs. You’ll be getting pages as you’re getting handoffs…”

Adapting handoffs to the setting and context

Incorporate helpful delivery strategies

“…I really don’t stand during a sign out. If I’m going to give a sign out to a person, I like to sit down and have then sit next to me so we make sure they don’t feel that I’m rushing them, and then give a thorough sign out without…”

Appreciate others’ styles/preferences for handoff

“…I mean you kind of can read people and when like they’re shutting down. When they’re not listening and they’re writing something else or looking at their phone or like those are kinds of ways.”