The learning effects of within-unit handover report

Aims While there is increased practice of different types of patient handover, there is a paucity of systematic research examining physicians learning during such events. We aimed to examine ‘what is being learned’ and the factors determining the learning during a group within-unit handover context, in a tertiary children’s hospital. 

Methods Video-recorded observation of group handover events including all case-presentations informed a thematic framework analysis of learning themes and determinants of learning. Video-stimulated recall and semi-structured interviews were performed. Data analysis used NVivo software. 

Results Seven handover events (mean duration n=33 minutes; mean audience participants n=24), captured n=67 case-presentations, analysed to inform the learning topics and group dynamics. Nine semi-structured interviews (NCHDs)[mean duration n=33 minutes] allowed data triangulation to develop further understanding of the determinants of learning. Multiple areas encompassing physicians’ professional roles were learned, often gained explicitly through case-presentations when succinct and relevant (‘expert’ presentations). Observing clinical reasoning processes (including clinicians’ narrative thinking aloud), and learner-safety, were critical determinants of the learning environment. 

Discussion Face-to-face within-unit handover report is a powerful workplace learning event found to enhance many domains of physicians’ professional practice. Comparison, and application of the mechanisms facilitating this learning should be applied to related virtual-learning activities.