Evaluation of the I‐PASS Handover Model for Anatomy Dissections

Effective and efficient handover communication is critical for quality patient care through transitions of responsibility from one healthcare team to another. As these skills take time to develop, it is necessary for medical education to incorporate handovers in various applications. The small group anatomy lab setting provides an ideal environment for students to practice these skills. At the beginning of each lab, team leaders are responsible for delivering a handover of the previous dissection. At the Medical College of Georgia, the I‐PASS mnemonic for handovers (Illness Severity, Patient Summary, Action List, Situation Awareness and Contingency Planning, and Synthesis by Receiver) was adopted into the anatomy curriculum in 2018–2019, as this is the format students use in clerkships. Aim The purpose of this project was to evaluate the effectiveness of the I‐PASS handover model in the anatomy lab and to assess student perceptions and attitudes concerning this model. Methods First year medical students (n=192) provided formative feedback to members of the opposite dissection group performing the handover for each dissection. At the end of the academic year, students (n=162) completed a survey including questions assessing student perceptions and how often they used the I‐PASS model. Rating rubric data from the feedback exercises and survey were averaged, and narrative comments were themed, quantified, and analyzed. IRB approval was obtained from Augusta University. Results On average, I‐PASS handovers lasted ~11 minutes (SD ± 4 min 44 sec). The vast majority (92%) of peer feedback identified strengths of the provided handover. Students preferred handovers that included a comprehensive summary of the prior dissection, pointed out specific structures on cadavers, were detailed, and allowed opportunities to ask questions. At the end of the year, only 30% of respondents correctly identified what “I‐PASS” stands for. 62% of students reported rarely or never utilizing the I‐PASS mnemonic as they gave handovers, citing preferring to summarize the previous dissection in their own way and perceiving the model as inapplicable to cadavers. 68% of students reported the model was only slightly or not helpful for developing communication skills. 71% of students reported peer feedback received following their handovers was only slightly or not helpful, citing that feedback received was typically generic affirmative statements and rarely constructive criticism. Discussion and Conclusion Although the I‐PASS handover model was recommended as the standard for reviewing dissections, the vast majority of first year medical students reported not actually using it. This indicates a need for a revised model of handovers tailored to anatomy dissections. Students provided considerably more positive comments to their peers than suggestions for improvement, suggesting that students are uncomfortable giving constructive feedback to peers. Survey results indicate that students notice this trend and would have appreciated more constructive criticism on handovers. Taken together, these results suggest that strictly following the I‐PASS model for handovers in anatomy lab is not an effective way to practice giving patient handovers and does not provide students with constructive feedback on the development of their communication skills.