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Table 2 Key Stakeholder Opinions about the Risks and Benefits of a Learner Education Handover (LEH)

From: Key stakeholder opinions for a national learner education handover

Risks of the LEH Benefits of the LEH
“There are those occasional circumstances where you know, the sharing of information might make that fresh start difficult when a fresh start is actually the most useful thing. I think most of the time that’s actually not the case, but if we’re thinking about risks that’s what occurs to me.” – Postgraduate Medical Education Dean – 003-09 “The biggest benefit of a handover is an individualized teaching plan. I mean it can also be used in negative ways.” - Resident – 003-10
“I think that residency should be a clean slate for medical students and one of the reasons that I feel that way is because in certain situation or certain circumstances medical students may thrive or may not do so well. And the whole idea of residency is the change of environment.”- Medical Student – 001-01 “I mean what I like is I would like the idea of there being some continuity. But I don’t know how we can practically do it with a handover from every medical student to every training program. But I do like that continuing mentorship, continuing fostering certain skills. You know if there’s professionalism and mentoring that’s happening that that gets continued.” – Student Affairs Leader – 001-07
“In the UME program difficult students who come to our attention and sometimes they start to evoke negative emotions in us and similarly, there’s some students we feel extremely positive about. At the end then there’s a whole swath of people in the middle, so there’s always bias in these assessments.” - Undergraduate Medical Education Dean – 002-05 “I think one of the things that handover should be helpful for is allowing programs to know what level of responsibility they can be assigning to people within those early weeks and months of their residency training. What skills do they have? And what things are they not really in a position to be able to do independently? And I think ultimately that should be in the interest of better patient care.” Postgraduate Medical Education Dean – 002-06
“I think for the learner’s standpoint I think that their biggest concern would be risk of bias. And they wouldn’t want for people to have presupposed or pre-judge them based on something which they believe or have in fact resolved in their previous training. So how that information is then disseminated or circulated once it’s in the hands of a program director I think is a key point. Just as we deal with forward feeding/orienting preceptors to learners within residency, I think it’s the same at that transition point. So it is a very tricky line between sort of the negative connotations of forward feeding as opposed to the more positive connotation of having a positive or responsive or appropriate learning environment for a learner. How exactly that balance is met I think is exactly why we’re having this conversation.” – Program Director – 002-02 “Well, if its objective information that has been validated and is being transmitted with the intention of allowing the student to function better in the new environment. That’s going to be clear to everybody. I mean it’s going to be documented and the particular accommodations are going to be already understood. And the student is going to be aware that that information is going forward and why.” Undergraduate Medical Education Dean – 001-03
“When you’re handing over that kind of information you have to recognize that the residency programs don’t really know the resident yet, so it’s hard to really put that information in context of their overall person and their skills and their performance.” Resident – 001-02 “…we know right away we’re going to have applicants who are misrepresenting their file. We have applicants that are going to be practicing without a license and getting in trouble right off the bat. We have individuals who aren’t going to properly disclose emotional and anxiety issues who are going to end up on physical leaves a right away.” - Medical Regulatory Authority Representative – 003-01
  1. aLeave of absence due to illness