• Jeanne M Farnan, J A M Paro, R M Rodriguez, S T Reddy, L I Horwitz, J K Johnson, and V M Arora.
• Section of Hospital Medicine, Department of Medicine, The University of Chicago, 5841 South Maryland Ave., MC 2007, Chicago, IL 60637, USA. jfarnan@medicine.bsd.uchicago.edu
• J Gen Intern Med. 2010 Feb 1; 25 (2): 129134129-34.

AimThe Observed Simulated Hand-off Experience (OSHE) was created to evaluate medical students' sign-out skills using a real-time assessment tool, the Hand-off CEX.SettingThirty-two 4th year medical students participated as part of an elective course.Program DescriptionOne week following an interactive workshop where students learned effective hand-off strategies, students participated in an experience in which they performed a hand-off of a mock patient using simulated history and physical examination data and a brief video.Program EvaluationInternal medicine residents served as standardized hand-off receivers and were trained on expectations. Students were provided feedback using a newly developed Hand-off CEX, based on the "Mini-CEX," which rates overall hand-off performance and its components on a 9-point Likert-type scale. Outcomes included performance ratings and pre- and post-student self-assessments of hand-off preparedness. Data were analyzed using Wilcoxon signed-rank tests and descriptive statistics. Resident receivers rated overall student performance with a mean score of 6.75 (range 4-9, maximum 9). Statistically significant improvement was observed in self-perceived preparedness for performing an effective hand-off (67% post- vs. 27% pre-reporting 'well-prepared,' p<0.009).DiscussionThis brief, standardized hand-off training exercise improved students' confidence and was rated highly by trained observers. Future work focuses on formal validation of the Hand-off CEX instrument.Electronic Supplementary MaterialThe online version of this article (doi:10.1007/s11606-009-1170-y) contains supplementary material, which is available to authorized users.

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