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Using standardized videos to validate a measure of handoff quality: The handoff mini‐clinical examination exercise
Author(s) -
Arora Vineet M.,
Berhie Saba,
Horwitz Leora I.,
Saathoff Mark,
Staisiunas Paul,
Farnan Jeanne M.
Publication year - 2014
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.1002/jhm.2185
Subject(s) - handover , medicine , cronbach's alpha , accreditation , concordance , graduate medical education , reliability (semiconductor) , medical education , quality (philosophy) , test (biology) , variance (accounting) , standardized test , psychology , computer science , psychometrics , philosophy , epistemology , physics , power (physics) , quantum mechanics , clinical psychology , mathematics education , business , computer network , biology , paleontology , accounting
BACKGROUND The most recent iteration of the Accreditation Council for Graduate Medical Education duty‐hour regulations includes language mandating handoff education for trainees and assessments of handoff quality by residency training programs. However, there is a lack of validated tools for the assessment of handoff quality and for use in trainee education. METHODS Faculty at 2 sites (University of Chicago and Yale University) were recruited to participate in a workshop on handoff education. Video‐based scenarios were developed to represent varying levels of performance in the domains of communication, professionalism, and setting. Videos were shown in a random order, and faculty were instructed to use the Handoff Mini‐Clinical Examination Exercise (CEX), a paper‐based instrument with qualitative anchors defining each level of performance, to rate the handoffs. RESULTS Forty‐seven faculty members (14 at site 1; 33 at site 2) participated in the validation workshops, providing a total of 172 observations (of a possible 191 [96%]). Reliability testing revealed a Cronbach α of 0.81 and Kendall coefficient of concordance of 0.59 (>0.6 = high reliability). Faculty were able to reliably distinguish the different levels of performance in each domain in a statistically significant fashion (ie, unsatisfactory professionalism mean 2.42 vs satisfactory professionalism 4.81 vs superior professionalism 6.01, P < 0.001 trend test). Two‐way analysis of variance revealed no evidence of rater bias. CONCLUSIONS Using standardized video‐based scenarios highlighting differing levels of performance, we were able to demonstrate evidence that the Handoff Mini‐CEX can draw reliable and valid conclusions regarding handoff performance. Future work to validate the tool in clinical settings is warranted. Journal of Hospital Medicine 2014;9:441–446. © 2014 Society of Hospital Medicine