Development and pilot evaluation of a structured curriculum for surgical handover

Development and pilot evaluation of a structured curriculum for surgical handover | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development and pilot evaluation of a structured curriculum for surgical handover Jessica M Ryan, Walter Eppich, Dara O Kavanagh, Anastasija Simiceva, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6777652/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 22 Oct, 2025 Read the published version in BMC Medical Education → Version 1 posted 11 You are reading this latest preprint version Abstract Background Effective handover communication is a core professional competency in graduate medical education, yet very few junior doctors working in surgery receive formal training. A structured curriculum was developed and piloted to teach best practices in surgical handover, based on a recognised curricular framework. Methods The study was carried out at two academic tertiary hospitals in Dublin, Ireland. Interns attending mandatory weekly teaching sessions participated in a 60-minute intervention combining didactic teaching, video demonstration, small group simulation, and facilitated discussion. Self-reported confidence in delivering and participating in handover was assessed using pre- and post-session surveys. Post-session feedback on curriculum content and format was also collected. Results A total of 59 interns attended the teaching sessions, with 35 providing paired pre- and post-session data. Self-reported confidence significantly improved across all assessed domains assessed (p<0.001), including confidence in handing over to peers and senior colleagues, asking clarifying questions during handover, and providing a summary or ‘readback’ at the end of handover. Feedback from 46 participants indicated that the session was well-received, with video demonstrations and simulated practice rated most helpful. Didactic teaching and peer feedback were rated least helpful. A majority (76.1%; n=35) reported that the session would lead to changes in their handover practice. Conclusions This pilot study demonstrated that a simulation-based curriculum is effective in improving interns’ self-reported confidence in delivering and receiving surgical handover. The teaching session was well-received, easily integrated into existing institutional infrastructure, and required minimal resources to carry out. Surgical education handover handoff surgical handover medical education INTRODUCTION Clinical handover is a recognised priority for patient safety 1 and has serious implications if not performed well. 2-4 Effective handover communication is a core professional competency that should be taught and assessed during graduate medical education. 5 Surgical handover presents unique challenges, including tight time constraints, competing clinical demands at the time of handover, 6 a high level of patient acuity, and frequent transitions of care throughout the perioperative period. Active involvement of early career doctors in handover has clear benefits for patient care. 7 Yet, despite its importance, only 11% of junior doctors working in surgery receive formal handover training, 6 and until recently, no evidence-based guidance was available to support the development of dedicated curricula. A recent review by the authors proposed recommendations regarding the optimal approach, format, and content for educational programmes in surgical handover; 8 however, these have yet to be evaluated in practice. To address this gap, a structured curriculum was developed and piloted based on these recommendations, designed to teach best practices for surgical handover. This study aimed to pilot this curriculum during routine in-hospital intern teaching and to assess its impact on participants’ self-reported level of confidence in delivering and participating in surgical handover. Findings from this study will inform further refinement of the curriculum and implementation on a larger scale. METHODS A curriculum for teaching best practices in surgical handover practices was developed using a recognised framework 8 and piloted at two hospital sites using an interventional cohort study with a before and after design. The teaching sessions were carried out on the 23 rd of January 2024 (Site A) and the 8 th of February 2024 (Site B). Prospective study approval was received at both sites (CA2023/136 and 3714) and the GREET guideline for reporting evidence-based practice educational interventions and teaching 9 was followed to guide reporting of this study. Setting and population This study was conducted at two academic tertiary referral centres in Dublin, Ireland, with 500 and 820 beds, and catchment populations of 644,000 and 290,000 people, respectively. Both sites carry out weekly, one-hour, lunchtime intern teaching sessions for which attendance is mandatory. The curriculum was delivered during two of these sessions, one in each hospital site, in January and February 2024. The teaching topic was pre-approved for inclusion by session coordinators from the Royal College of Surgeons in Ireland and Trinity College Dublin. Participants included interns working across all hospital departments who attended the in-person teaching sessions. Food was provided to interns as the teaching sessions are scheduled to happen during lunch. Resource use The teaching session was delivered using existing institutional infrastructure. It involved a one-hour session facilitated by two staff members (a primary and an assistant instructor), with approximately 60 minutes of preparation time in advance. Supporting materials included printed handover documents and pre-recorded video demonstrations, which required one hour of filming. Standard audiovisual equipment was used (projector with PowerPoint slides, ©Microsoft 2025), and interactive polling was conducted using free online software. Sessions were held in lecture theatres with internet access, booked for a one-hour duration. Curriculum description The curriculum was developed using a recognised framework 8 and was grounded in social constructivism learning theory, which asserts that knowledge is built through social interactions and collaboration. 10 It was delivered by a primary instructor (JMR) who was completing a Doctor of Philosophy in surgical handover and had almost 10 years of experience working in surgery at the time. The curriculum was delivered over a 60-minute interactive teaching session designed to introduce best practices for surgical handover and combined didactic teaching, video demonstration, small-group simulation exercises, and facilitated group discussion (Table 1). Teaching began with a brief overview of the definition and importance of clinical handover, followed by the steps of the SIPS Surgical Handover System. 11 Role-play videos created by the instructors, which demonstrated examples of suboptimal and effective handover, were then shown to stimulate discussion around common errors and effective strategies. Interns then engaged in small group (n=3) simulated verbal handover practice using realistic examples of three patient cases included in sample handover documents. Each participant had an opportunity to deliver and receive a simulated handover, and provide peer feedback. The session concluded with group discussion and reflection on the simulation exercises, followed by repeat polling to capture changes in perception (Additional File 1.pdf) and feedback (Additional File 2.pdf) on the session. Table 1. Surgical handover curriculum Time Activity 00:00 - 00:15 Introduction and didactic teaching Session introduction, interactive poll, and 10-minute slide-based lecture covering the principles and importance of handover, including steps of the SIPS Surgical Handover System 11 00:15 - 00:25 Video demonstration and group discussion Video demonstration of poor and well-executed handovers, followed by a group discussion of video content 00:25 - 00:35 Preparation for simulated practice Participants divided into groups of three, where each person was provided with an example of a written handover documents. The upcoming simulation exercise was explained, and they were given time to familiarise themselves with patient information. A visual aid for the handover method was made available (using slides and distributed cards for ID lanyards) 00:35 - 00:50 Simulated handover practice and peer feedback Each group conducted three simulated handovers (4 minutes each), with 1-minute for peer feedback and discussion after each 00:50 - 00:60 Session debrief A whole-group discussion was then carried out, followed by a repeat interactive poll, and collection of participant feedback on the session Table 1 caption. This table provides a description of the curriculum with timings of each component. Outcome measures and data collection The primary outcome was interns' self-reported level of confidence in delivering and participating in surgical handover, which reflects a Kirkpatrick level I outcome. 12 These were assessed using pre- and post-session surveys (polls) with 10-point Likert scales (Additional File 1.pdf). The secondary outcome was participant feedback on the class content and format was assessed at the end of the session using an 8-item survey (Additional File 2.pdf). 13,14 Pre- and post-session surveys were distributed using QR codes and responses were recorded anonymously. Pre-session surveys additionally captured information on participants' current clinical posts, prior handover education and familiarity with the taught surgical handover method. Statistical methods Data were analysed using Stata (17.0©2021, StataCorp, Texas). Categorical data were presented as absolute values and percentages, and continuous data as mean (standard deviation, SD). Comparative analyses of quantitative data were performed using chi-squared test for categorical data, Likert scales were coded numerically and analysed using paired t-tests. 15 All tests of significance were two-tailed, with p <0.05 indicating statistical significance. RESULTS Participant characteristics A total of 59 interns attended the teaching sessions (Site A: n=27; Site B: n=32), all of whom responded to at least one in-session survey question. Paired pre- and post-session polling data were available for 35 participants (59.3%). Demographic data were provided by 38 interns (64.4%); of these, 43.2% (n=16) were working in surgical posts at the time of the session, 51.3% (n=19) in medical specialties, and 5.4% (n=2) in other departments. Only five interns (13.9% of 36 respondents to this question) reported receiving formal handover training previously. Self-reported confidence in handover There was a statistically significant improvement in self-reported confidence across all four domains assessed (giving handover to another intern, giving handover to a senior colleague, asking clarifying questions during handover, and summarising to the team at the end of the handover meeting) following the teaching session (p < 0.001; Table 2). Attendee feedback Post-session feedback was received from 46 interns (78%). Interns reported that the session was useful to clinical practice (mean Likert score: 4.2 ± 1.0), provided an effective review of the topic (4.1 ± 1.1), and would recommend it to others (3.9 ± 1.2). In terms of class content, video examples of handover were rated the most helpful (4.1 ± 0.8), followed by simulated practice (3.8 ± 1.1). Didactic slides (3.6 ± 1.0) and peer feedback (3.4 ± 1.1) were rated lowest. A majority (76.1%; n=35) reported that the session would lead to changes in their handover practice. Cronbach’s alpha for the 7-item Likert scale for attendee feedback (Additional File 2.pdf) was 0.9, indicating excellent internal consistency. Open-text comments Five interns (10.8%) provided open-text comments, highlighting the need for senior leadership to model improved handover behaviours: “Change in culture should come from top down.” – Intern B1 One participant noted the session’s relevance may vary depending on clinical role: “Applies better to regs and surgical interns. Not relevant to general interns.” – Intern B2 Another pointed out environmental and contextual barriers: “Better not to hand over at ED nurses station [because it is] loud busy and you’re regularly interrupted” – Intern B2 Participants suggested improvements, including more time for simulated practice and more realistic and complex case materials: “The simulated part was a little too rapid.” – Intern B3 “3 patient handover wouldn't be the same as 7+ patients (which is the norm). Would like more tips for a longer and more complicated handover.” – Intern B4 One intern commented positively on the teaching approach: “More tutorials should be in the same style.” – Intern A4 Table 2. Summary of handover confidence ratings pre- and post-teaching session Question n Pre-teaching Mean (SD) CI Post-teaching Mean (SD) CI p How comfortable would you be giving patient handover to another intern? 31 8 (1.3) 7.5 - 8.5 9 (.8) 8.7 - 9.3 <0.0001* How comfortable would you be giving patient handover to a senior colleague? 34 6.3 (1.5) 5.7 - 6.8 7.4 (1.5) 6.9 - 7.9 <0.0001* How comfortable would you be posing necessary clarifying questions during team handover? 35 6.4 (2.1) 5.6 - 7.1 7.5 (1.7) 6.9 - 8.1 0.0003* How comfortable would you be providing a summary to your team at the end of a handover meeting? 27 6.5 (1.8) 5.8 -7.2 7.5 (1.4) 6.9 - 8 0.0004* Table 2 caption. Table 2 provides a summary of intern handover confidence ratings pre- and post-teaching session (measured on a 10-point Likert scale). * Analysed using paired t-test CI, Confidence interval; SD, Standard deviation DISCUSSION This pilot study demonstrated that the previously described curricular framework for surgical handover 8 can effectively be used to develop a simulation-based teaching session for interns, leading to improved self-reported confidence in delivering and receiving surgical handover. Video demonstrations and simulated handover practice were rated highest in terms of content and methods used, with the provision of peer feedback rated the lowest. Interns reported high levels of satisfaction with the session and the majority felt that it would lead to changes in their practice. Survey responses suggest that simulated practice should be longer, using more complex scenarios, and that time spent on didactic teaching should be reduced. Most participants had not received prior handover training, consistent with previous literature. 6 The findings reported here reinforce the need for structured, formal training in handover as part of graduate medical education 5 and support simulated handover practice in enhancing learner confidence, as well as the value of video demonstrations as a teaching tool. 16 In-person simulation, which is preferred by students, 4 may be particularly appropriate for first-time learners. 8 This curriculum can be adapted for use in lower resource settings. It was easily incorporated into existing institutional teaching infrastructure and required minimal resources to carry out. In teaching settings without audiovisual equipment or internet access, in-person role-played handover demonstrations could be used instead of video. Given that students do not rate didactic teaching highly 4 and slide-based presentations may negatively impact learning, 17 the introductory component of the session could also be conducted without slides to further reduce required resources. These factors make the curriculum particularly accessible for resource-limited settings. Student feedback suggests that modifications to the curriculum are required, particularly in the format of simulation, which was perhaps too simplistic, and may not have given students enough time to both familiarise themselves with patient details, deliver an effective handover, and receive feedback. Interestingly, although previous work suggests that peer feedback is effective, 8 the current findings indicate otherwise, suggesting that while feedback is well-received, it may be better delivered on an individual level by session faculty as in previous studies. 16 This pilot study was limited in its outcome assessment, which was restricted to Kirkpatrick level I outcomes. 12 It was also conducted in a single geographic area with a small number of learners, limiting generalisability. Additionally, the feedback response rate, while high, did not capture the views of all attendees. Future studies should assess higher level Kirkpatrick outcomes, including retention of teaching, real-world impact on handover quality and patient outcomes 12 using a revised curriculum informed by the above feedback. CONCLUSION This pilot study demonstrated that a simulation-based curriculum is effective in improving interns’ self-reported confidence in delivering and receiving surgical handover. The teaching session was well-received, easily integrated into existing institutional infrastructure, and required minimal resources to carry out. Participant feedback highlighted areas for improvement, particularly around simulated practice and the receipt of performance feedback. These findings will inform future modifications to the program with assessment of higher-level Kirkpatrick outcomes. Declarations Ethics approval and consent to participate: Prospective approval for this quality improvement initiative was obtained from the Audit and Quality departments of Beaumont Hospital (CA2023/136) and Tallaght University Hospital (3714). The teaching activities described here were mandated as part of quality improvement initiatives within the institutions, and as part of intern education, therefore consent was deemed unnecessary. This study adhered to the Declaration of Helsinki. Consent for publication: Not applicable. Availability of data and materials: All data generated or analysed during this study are included in this published article and its additional files. Competing interests: The authors declare that they have no competing interests. Funding: This work was supported by the Bon Secours Hospital in Dublin, Ireland, via the Royal College of Surgeons in Ireland (RCSI) StAR PhD Programme (grant agreement 22253A02) and the Medical Protection Society (MPS) Foundation (grant agreement 24416A001). The funding organisations had no role in study design, implementation, or analysis. Authors' contributions: Detailed according to CRediT’s Contributor Roles JMR : Conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, visualization, writing – original draft WE: Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing – review & editing DOK: Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing – review & editing AS: Funding acquisition, investigation, resources, project administration, supervision, validation, writing – original draft, writing – review & editing TVM: Data curation, resources, methodology, investigation, writing – review & editing DMcN: Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing – review & editing Acknowledgements: Not applicable Clinical trial number: Not applicable References Abdellatif A, Bagian JP, Barajas ER, Cohen M, Cousins D, Denham CR, et al. Communication during patient hand-overs: patient safety solutions, volume 1, solution 3, May 2007. Jt Comm J Qual Patient Saf. 2007;33(7):439-442. https://doi.org/10.1016/S1553-7250(07)33128-0 Horwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. Consequences of inadequate sign-out for patient care. Arch Intern Med. 2008;168(16):1755-1760. https://doi.org/10.1001/archinte.168.16.1755 Bougeard AM, Watkins B. Transitions of care in the perioperative period–a review. Clin Med (Lond). 2019;19(6):446-449. https://doi.org/10.7861/clinmed.2019.0235 Desmedt M, Ulenaers D, Grosemans J, Hellings J, Bergs J. Clinical handover and handoff in healthcare: a systematic review of systematic reviews. Int J Qual Health Care. 2021;33(1):mzaa170. https://doi.org/10.1093/intqhc/mzaa170 Accreditation Council for Graduate Medical Education. ACGME Common Program Requirements (Residency) 2025 Reformatted. Chicago, IL: ACGME; 2025. Ryan JM, Simiceva A, Toale C, Eppich W, Kavanagh DO, McNamara DA. Assessing current handover practices in surgery: A survey of non-consultant hospital doctors in Ireland. Surgeon. 2024;22(6);338-343. https://doi.org/10.1016/j.surge.2024.04.011 Murnaghan N, Ryan JM, Duggan WP, McNamara DA. Intern involvement in emergency general surgical handover and implications for patient care. The Surgeon 2025. Simiceva A, Ryan JM, Eppich W, Kavanagh DO, McNamara DA, Morris M. Developing an educational blueprint for surgical handover curricula: a critical review of the evidence. Adv in Health Sci Educ. 2025. https://doi.org/10.1007/s10459-025-10410-1 Phillips AC, Lewis LK, McEvoy MP, Galipeau J, Glasziou P, Moher D, et al. Development and validation of the guideline for reporting evidence-based practice educational interventions and teaching (GREET). BMC Medical Education. 2016;16(1):237. De Mello RR. From constructivism to dialogism in the classroom. Theory and learning environments. International Journal of Educational Psychology. 2012;1(2):127-52. Ryan JM et al. The SIPS Surgical Handover System. In press. 2025. Kirkpatrick D, Kirkpatrick J. Evaluating training programs: The four levels: Berrett-Koehler Publishers; 2006. Telem DA, Buch KE, Ellis S, Coakley B, Divino CM. Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results. Arch Surg. 2011;146(1):89-93. https://doi.org/10.1001/archsurg.2010.294 Gaffney S, Farnan JM, Hirsch K, McGinty M, Arora VM. The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance. J Gen Intern Med. 2016;31(4):438-441. https://doi.org/10.1007/s11606-016-3591-8 Sullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5(4):541-542. https://doi.org/10.4300/jgme-5-4-18 Holt N, Crowe K, Lynagh D, Hutcheson Z. Is there a need for formal undergraduate patient handover training and could an educational workshop effectively provide this? A proof-of-concept study in a Scottish Medical School. BMJ Open. 2020;10(2):e034468. https://doi.org/10.1136/bmjopen-2019-034468 Wecker C. Slide presentations as speech suppressors: When and why learners miss oral information. Comput Educ. 2012;59(2):260-273. https://doi.org/10.1016/j.compedu.2012.01.013 Supplementary Files AdditionalFile1.pdf ADDITIONAL FILES Additional File 1.pdf Copy of pre- and post-session survey with 10-point Likert scales to assess interns' self-reported level of confidence in delivering and participating in surgical handover AdditionalFile2.pdf Additional File 2.pdf Copy of post-session survey to assess participant feedback on the class content and format Cite Share Download PDF Status: Published Journal Publication published 22 Oct, 2025 Read the published version in BMC Medical Education → Version 1 posted Editorial decision: Revision requested 06 Aug, 2025 Reviews received at journal 02 Aug, 2025 Reviews received at journal 16 Jul, 2025 Reviewers agreed at journal 11 Jul, 2025 Reviewers agreed at journal 10 Jul, 2025 Reviewers agreed at journal 10 Jul, 2025 Reviewers invited by journal 12 Jun, 2025 Editor assigned by journal 12 Jun, 2025 Editor invited by journal 11 Jun, 2025 Submission checks completed at journal 11 Jun, 2025 First submitted to journal 11 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6777652","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":475855285,"identity":"eb349093-251e-4b89-b6f6-db74987dd99a","order_by":0,"name":"Jessica M 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safety\u003csup\u003e1\u003c/sup\u003e and has serious implications if not performed well.\u003csup\u003e2-4\u003c/sup\u003e Effective handover communication is a core professional competency that should be taught and assessed during graduate medical education.\u003csup\u003e5\u003c/sup\u003e Surgical handover presents unique challenges, including tight time constraints, competing clinical demands at the time of handover,\u003csup\u003e6\u003c/sup\u003e a high level of patient acuity, and frequent transitions of care throughout the perioperative period.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eActive involvement of early career doctors in handover has clear benefits for patient care.\u003csup\u003e7\u003c/sup\u003e Yet, despite its importance, only 11% of junior doctors working in surgery receive formal handover training,\u003csup\u003e6\u003c/sup\u003e and until recently, no evidence-based guidance was available to support the development of dedicated curricula. A recent review by the authors proposed recommendations regarding the optimal approach, format, and content for educational programmes in surgical handover;\u003csup\u003e8\u003c/sup\u003e however, these have yet to be evaluated in practice.\u003c/p\u003e\n\u003cp\u003eTo address this gap, a structured curriculum was developed and piloted based on these recommendations, designed to teach best practices for surgical handover. This study aimed to pilot this curriculum during routine in-hospital intern teaching and to assess its impact on participants’ self-reported level of confidence in delivering and participating in surgical handover. Findings from this study will inform further refinement of the curriculum and implementation on a larger scale.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003eA curriculum for teaching best practices in surgical handover practices was developed using a recognised framework\u003csup\u003e8\u003c/sup\u003e and piloted at two hospital sites using an interventional cohort study with a before and after design. The teaching sessions were carried out on the\u0026nbsp;23\u003csup\u003erd\u003c/sup\u003e of January 2024 (Site A) and the 8\u003csup\u003eth\u003c/sup\u003e of February 2024 (Site B).\u0026nbsp;Prospective study approval was received at both sites (CA2023/136 and 3714)\u0026nbsp;and the GREET guideline for reporting evidence-based practice educational interventions and teaching\u003csup\u003e9\u003c/sup\u003e was followed to guide reporting of this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSetting and population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted at two academic tertiary referral centres in Dublin, Ireland, with 500 and 820 beds, and catchment populations of 644,000 and 290,000 people, respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBoth sites carry out weekly, one-hour, lunchtime intern teaching sessions for which attendance is mandatory. The curriculum was delivered during two of these sessions, one in each hospital site, in January and February 2024. The teaching topic was pre-approved for inclusion by session coordinators from the Royal College of Surgeons in Ireland and Trinity College Dublin. Participants included interns working across all hospital departments who attended the in-person teaching sessions. Food was provided to interns as the teaching sessions are scheduled to happen during lunch.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResource use\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe teaching session was delivered using existing institutional infrastructure. It involved a one-hour session facilitated by two staff members (a primary and an assistant instructor), with approximately 60 minutes of preparation time in advance. Supporting materials included printed handover documents and pre-recorded video demonstrations, which required one hour of filming. Standard audiovisual equipment was used (projector with PowerPoint slides, \u0026copy;Microsoft 2025), and interactive polling was conducted using free online software. Sessions were held in lecture theatres with internet access, booked for a one-hour duration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCurriculum description\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe curriculum was\u0026nbsp;developed using a recognised framework\u003csup\u003e8\u003c/sup\u003e and was grounded in social constructivism learning theory, which asserts that knowledge is built through social interactions and collaboration.\u003csup\u003e10\u003c/sup\u003e It was delivered by a primary instructor (JMR) who was completing a Doctor of Philosophy in surgical handover and had almost 10 years of experience working in surgery at the time.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe curriculum was delivered over a 60-minute interactive teaching session designed to introduce best practices for surgical handover and combined didactic teaching, video demonstration, small-group simulation exercises, and facilitated group discussion (Table 1). Teaching began with a brief overview of the definition and importance of clinical handover, followed by the steps of the SIPS Surgical Handover System.\u003csup\u003e11\u003c/sup\u003e Role-play videos created by the instructors, which demonstrated examples of suboptimal and effective handover, were then shown to stimulate discussion around common errors and effective strategies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInterns then engaged in small group (n=3) simulated verbal handover practice using realistic examples of three patient cases included in sample handover documents. Each participant had an opportunity to deliver and receive a simulated handover, and provide peer feedback. The session concluded with group discussion and reflection on the simulation exercises, followed by repeat polling to capture changes in perception (Additional File 1.pdf) and feedback (Additional File 2.pdf) on the session.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Surgical handover curriculum\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eActivity\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e00:00 - 00:15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIntroduction and didactic teaching\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eSession introduction, interactive poll, and 10-minute slide-based lecture covering the principles and importance of handover, including steps of the SIPS Surgical Handover System\u003csup\u003e11\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e00:15 - 00:25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVideo demonstration and group discussion\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eVideo demonstration of poor and well-executed handovers, followed by a group discussion of video content\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e00:25 - 00:35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePreparation for simulated practice\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eParticipants divided into groups of three, where each person was provided with an example of a written handover documents. The upcoming simulation exercise was explained, and they were given time to familiarise themselves with patient information. A visual aid for the handover method was made available (using slides and distributed cards for ID lanyards)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e00:35 - 00:50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSimulated handover practice and peer feedback\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eEach group conducted three simulated handovers (4 minutes each), with 1-minute for peer feedback and discussion after each\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e00:50 - 00:60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSession debrief\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eA whole-group discussion was then carried out, followed by a repeat interactive poll, and collection of participant feedback on the session\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1 caption.\u003c/strong\u003e This table provides a description of the curriculum with timings of each component.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome measures and data collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe primary outcome was interns\u0026apos; self-reported level of confidence in delivering and participating in surgical handover, which reflects a\u0026nbsp;Kirkpatrick level I outcome.\u003csup\u003e12\u003c/sup\u003e These were assessed using pre- and post-session surveys (polls) with 10-point Likert scales (Additional File 1.pdf). The secondary outcome was participant feedback on the class content and format was assessed at the end of the session using an 8-item survey (Additional File 2.pdf).\u003csup\u003e13,14\u003c/sup\u003e Pre- and post-session surveys were distributed using QR codes and responses were recorded anonymously. Pre-session surveys additionally captured information on participants\u0026apos; current clinical posts, prior handover education and familiarity with the taught surgical handover method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData were analysed using Stata (17.0\u0026copy;2021, StataCorp, Texas). Categorical data were presented as absolute values and percentages, and continuous data as mean (standard deviation, SD). Comparative analyses of quantitative data were performed using chi-squared test for categorical data, Likert scales were coded numerically and analysed using paired t-tests.\u003csup\u003e15\u003c/sup\u003e All tests of significance were two-tailed, with \u003cem\u003ep\u003c/em\u003e\u0026lt;0.05 indicating statistical significance.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eParticipant characteristics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 59 interns attended the teaching sessions (Site A: n=27; Site B: n=32), all of whom responded to at least one in-session survey question. Paired pre- and post-session polling data were available for 35 participants (59.3%). Demographic data were provided by 38 interns (64.4%); of these, 43.2% (n=16) were working in surgical posts at the time of the session, 51.3% (n=19) in medical specialties, and 5.4% (n=2) in other departments. Only five interns (13.9% of 36 respondents to this question) reported receiving formal handover training previously.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelf-reported confidence in handover\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was a statistically significant improvement in self-reported confidence across all four domains assessed (giving handover to another intern, giving handover to a senior colleague, asking clarifying questions during handover, and summarising to the team at the end of the handover meeting) following the teaching session (p \u0026lt; 0.001; Table 2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAttendee feedback\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePost-session feedback was received from 46 interns (78%). Interns reported that the session was useful to clinical practice (mean Likert score: 4.2 \u0026plusmn; 1.0), provided an effective review of the topic (4.1 \u0026plusmn; 1.1), and would recommend it to others (3.9 \u0026plusmn; 1.2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eIn terms of class content,\u0026nbsp;video examples of handover were rated the most helpful (4.1 \u0026plusmn; 0.8), followed by simulated practice (3.8 \u0026plusmn; 1.1). Didactic slides (3.6 \u0026plusmn; 1.0) and peer feedback (3.4 \u0026plusmn; 1.1) were rated lowest. A majority (76.1%; n=35) reported that the session would lead to changes in their handover practice. Cronbach\u0026rsquo;s alpha for the 7-item Likert scale for attendee feedback\u0026nbsp;(Additional File 2.pdf)\u0026nbsp;was 0.9, indicating excellent internal consistency.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOpen-text comments\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFive interns (10.8%) provided open-text comments, highlighting the need for senior leadership to model improved handover behaviours:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Change in culture should come from top down.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern B1\u003c/p\u003e\n\u003cp\u003eOne participant noted the session\u0026rsquo;s relevance may vary depending on clinical role:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Applies better to regs and surgical interns. Not relevant to general interns.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern B2\u003c/p\u003e\n\u003cp\u003eAnother pointed out environmental and contextual barriers:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;Better not to hand over at ED nurses station [because it is] loud busy and you\u0026rsquo;re regularly interrupted\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern B2\u003c/p\u003e\n\u003cp\u003eParticipants suggested improvements, including more time for simulated practice and more realistic and complex case materials:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;The simulated part was a little too rapid.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern B3\u003cbr\u003e\u0026nbsp;\u0026ldquo;3 patient handover wouldn\u0026apos;t be the same as 7+ patients (which is the norm). Would like more tips for a longer and more complicated handover.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern B4\u003c/p\u003e\n\u003cp\u003eOne intern commented positively on the teaching approach:\u003c/p\u003e\n\u003cp\u003e\u0026ldquo;More tutorials should be in the same style.\u0026rdquo;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026ndash; Intern A4\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Summary of handover confidence ratings pre- and post-teaching session\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"623\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eQuestion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003en\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-teaching\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-teaching\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eMean (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eCI\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003ep\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow comfortable would you be giving patient handover to another intern?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8 (1.3) \u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7.5 - 8.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9 (.8)\u003c/p\u003e\n \u003cp\u003e8.7 - 9.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.0001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow comfortable would you be giving patient handover to a senior colleague?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.3 (1.5)\u003c/p\u003e\n \u003cp\u003e5.7 - 6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.4 (1.5)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6.9 - 7.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026lt;0.0001*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow comfortable would you be posing necessary clarifying questions during team handover?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.4 (2.1)\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5.6 - 7.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.5 (1.7)\u003c/p\u003e\n \u003cp\u003e6.9 - 8.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0003*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHow comfortable would you be providing a summary to your team at the end of a handover meeting?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e6.5 (1.8)\u003c/p\u003e\n \u003cp\u003e5.8 -7.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e7.5 (1.4)\u003c/p\u003e\n \u003cp\u003e6.9 - 8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0.0004*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2 caption.\u0026nbsp;\u003c/strong\u003eTable 2 provides a summary of intern handover confidence ratings pre- and post-teaching session (measured on a 10-point Likert scale).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e*\u003c/strong\u003eAnalysed using paired t-test\u003c/p\u003e\n\u003cp\u003eCI, Confidence interval; SD, Standard deviation\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis pilot study demonstrated that the previously described curricular framework for surgical handover\u003csup\u003e8\u003c/sup\u003e can effectively be used to develop a simulation-based teaching session for interns, leading to improved self-reported confidence in delivering and receiving surgical handover. Video demonstrations and simulated handover practice were rated highest in terms of content and methods used, with the provision of peer feedback rated the lowest. Interns reported high levels of satisfaction with the session and the majority felt that it would lead to changes in their practice. Survey responses suggest that simulated practice should be longer, using more complex scenarios, and that time spent on didactic teaching should be reduced.\u003c/p\u003e\n\u003cp\u003eMost participants had not received prior handover training, consistent with previous literature.\u003csup\u003e6\u003c/sup\u003e The findings reported here reinforce the need for structured, formal training in handover as part of graduate medical education\u003csup\u003e5\u003c/sup\u003e and support simulated handover practice in enhancing learner confidence, as well as the value of video demonstrations as a teaching tool.\u003csup\u003e16\u003c/sup\u003e In-person simulation, which is preferred by students,\u003csup\u003e4\u003c/sup\u003e may be particularly appropriate for first-time learners.\u003csup\u003e8\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eThis curriculum can be adapted for use in lower resource settings. It was easily incorporated into existing institutional teaching infrastructure and required minimal resources to carry out. In teaching settings without audiovisual equipment or internet access, in-person role-played handover demonstrations could be used instead of video. Given that students do not rate didactic teaching highly\u003csup\u003e4\u003c/sup\u003e and slide-based presentations may negatively impact learning,\u003csup\u003e17\u003c/sup\u003e the introductory component of the session could also be conducted without slides to further reduce required resources. These factors make the curriculum particularly accessible for resource-limited settings.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudent feedback suggests that modifications to the curriculum are required, particularly in the format of simulation, which was perhaps too simplistic, and may not have given students enough time to both familiarise themselves with patient details, deliver an effective handover, and receive feedback. Interestingly, although previous work suggests that peer feedback is effective,\u003csup\u003e8\u003c/sup\u003e the current findings indicate otherwise, suggesting that while feedback is well-received, it may be better delivered on an individual level by session faculty as in previous studies.\u003csup\u003e16\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis pilot study was limited in its outcome assessment, which was restricted to Kirkpatrick level I outcomes.\u003csup\u003e12\u003c/sup\u003e It was also conducted in a single geographic area with a small number of learners, limiting generalisability. Additionally, the feedback response rate, while high, did not capture the views of all attendees. Future studies should assess higher level Kirkpatrick outcomes, including retention of teaching, real-world impact on handover quality and patient outcomes\u003csup\u003e12\u003c/sup\u003e using a revised curriculum informed by the above feedback.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis pilot study demonstrated that a simulation-based curriculum is effective in improving interns\u0026rsquo; self-reported confidence in delivering and receiving surgical handover. The teaching session was well-received, easily integrated into existing institutional infrastructure, and required minimal resources to carry out. Participant feedback highlighted areas for improvement, particularly around simulated practice and the receipt of performance feedback. These findings will inform future modifications to the program with assessment of higher-level Kirkpatrick outcomes.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul type=\"disc\"\u003e\n \u003cli\u003e\u003cstrong\u003eEthics approval and consent to participate:\u0026nbsp;\u003c/strong\u003eProspective approval for this quality improvement initiative was obtained from the Audit and Quality departments of Beaumont Hospital (CA2023/136) and Tallaght University Hospital (3714). The teaching activities described here were mandated as part of quality improvement initiatives within the institutions, and as part of intern education, therefore consent was deemed unnecessary. This study adhered to the Declaration of Helsinki.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eConsent for publication:\u0026nbsp;\u003c/strong\u003eNot applicable.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAvailability of data and materials:\u0026nbsp;\u003c/strong\u003eAll data generated or analysed during this study are included in this published article and its additional files.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003eThe authors declare that they have no competing interests.\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003eThis work was supported by the Bon Secours Hospital in Dublin, Ireland, via the Royal College of Surgeons in Ireland (RCSI) StAR PhD Programme (grant agreement 22253A02) and the Medical Protection Society (MPS) Foundation (grant agreement 24416A001). The funding organisations had no role in study design, implementation, or analysis.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/strong\u003eDetailed according to CRediT\u0026rsquo;s Contributor Roles\u003cul type=\"circle\"\u003e\n \u003cli\u003e\u003cstrong\u003eJMR\u003c/strong\u003e: Conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, visualization, writing \u0026ndash; original draft\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eWE:\u003c/strong\u003e Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing \u0026ndash; review \u0026amp; editing\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eDOK:\u003c/strong\u003e Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing \u0026ndash; review \u0026amp; editing\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAS:\u003c/strong\u003e Funding acquisition, investigation, resources, project administration, supervision, validation, writing \u0026ndash; original draft, writing \u0026ndash; review \u0026amp; editing\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eTVM:\u003c/strong\u003e Data curation, resources, methodology, investigation, writing \u0026ndash; review \u0026amp; editing\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eDMcN:\u003c/strong\u003e Conceptualization, funding acquisition, investigation, methodology, visualization, supervision, validation, writing \u0026ndash; review \u0026amp; editing\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/li\u003e\n \u003cli\u003e\u003cstrong\u003eClinical trial number:\u0026nbsp;\u003c/strong\u003eNot applicable\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eAbdellatif A, Bagian JP, Barajas ER, Cohen M, Cousins D, Denham CR, et al. Communication during patient hand-overs: patient safety solutions, volume 1, solution 3, May 2007. Jt Comm J Qual Patient Saf. 2007;33(7):439-442. https://doi.org/10.1016/S1553-7250(07)33128-0 \u003c/li\u003e\n\u003cli\u003eHorwitz LI, Moin T, Krumholz HM, Wang L, Bradley EH. Consequences of inadequate sign-out for patient care. Arch Intern Med. 2008;168(16):1755-1760. https://doi.org/10.1001/archinte.168.16.1755 \u003c/li\u003e\n\u003cli\u003eBougeard AM, Watkins B. Transitions of care in the perioperative period\u0026ndash;a review. Clin Med (Lond). 2019;19(6):446-449. https://doi.org/10.7861/clinmed.2019.0235 \u003c/li\u003e\n\u003cli\u003eDesmedt M, Ulenaers D, Grosemans J, Hellings J, Bergs J. Clinical handover and handoff in healthcare: a systematic review of systematic reviews. Int J Qual Health Care. 2021;33(1):mzaa170. https://doi.org/10.1093/intqhc/mzaa170 \u003c/li\u003e\n\u003cli\u003eAccreditation Council for Graduate Medical Education. ACGME Common Program Requirements (Residency) 2025 Reformatted. Chicago, IL: ACGME; 2025. \u003c/li\u003e\n\u003cli\u003eRyan JM, Simiceva A, Toale C, Eppich W, Kavanagh DO, McNamara DA. Assessing current handover practices in surgery: A survey of non-consultant hospital doctors in Ireland. Surgeon. 2024;22(6);338-343. https://doi.org/10.1016/j.surge.2024.04.011 \u003c/li\u003e\n\u003cli\u003eMurnaghan N, Ryan JM, Duggan WP, McNamara DA. Intern involvement in emergency general surgical handover and implications for patient care. \u003cem\u003eThe Surgeon\u003c/em\u003e 2025.\u003c/li\u003e\n\u003cli\u003eSimiceva A, Ryan JM, Eppich W, Kavanagh DO, McNamara DA, Morris M. Developing an educational blueprint for surgical handover curricula: a critical review of the evidence. Adv in Health Sci Educ. 2025. https://doi.org/10.1007/s10459-025-10410-1 \u003c/li\u003e\n\u003cli\u003ePhillips AC, Lewis LK, McEvoy MP, Galipeau J, Glasziou P, Moher D, et al. Development and validation of the guideline for reporting evidence-based practice educational interventions and teaching (GREET). BMC Medical Education. 2016;16(1):237.\u003c/li\u003e\n\u003cli\u003eDe Mello RR. From constructivism to dialogism in the classroom. Theory and learning environments. International Journal of Educational Psychology. 2012;1(2):127-52.\u003c/li\u003e\n\u003cli\u003eRyan JM et al. The SIPS Surgical Handover System. In press. 2025.\u003c/li\u003e\n\u003cli\u003eKirkpatrick D, Kirkpatrick J. Evaluating training programs: The four levels: Berrett-Koehler Publishers; 2006.\u003c/li\u003e\n\u003cli\u003eTelem DA, Buch KE, Ellis S, Coakley B, Divino CM. Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results. Arch Surg. 2011;146(1):89-93. https://doi.org/10.1001/archsurg.2010.294 \u003c/li\u003e\n\u003cli\u003eGaffney S, Farnan JM, Hirsch K, McGinty M, Arora VM. The Modified, Multi-patient Observed Simulated Handoff Experience (M-OSHE): Assessment and Feedback for Entering Residents on Handoff Performance. J Gen Intern Med. 2016;31(4):438-441. https://doi.org/10.1007/s11606-016-3591-8 \u003c/li\u003e\n\u003cli\u003eSullivan GM, Artino AR Jr. Analyzing and interpreting data from Likert-type scales. J Grad Med Educ. 2013;5(4):541-542. https://doi.org/10.4300/jgme-5-4-18 \u003c/li\u003e\n\u003cli\u003eHolt N, Crowe K, Lynagh D, Hutcheson Z. Is there a need for formal undergraduate patient handover training and could an educational workshop effectively provide this? A proof-of-concept study in a Scottish Medical School. BMJ Open. 2020;10(2):e034468. https://doi.org/10.1136/bmjopen-2019-034468 \u003c/li\u003e\n\u003cli\u003eWecker C. Slide presentations as speech suppressors: When and why learners miss oral information. Comput Educ. 2012;59(2):260-273. https://doi.org/10.1016/j.compedu.2012.01.013\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Surgical education, handover, handoff, surgical handover, medical education","lastPublishedDoi":"10.21203/rs.3.rs-6777652/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6777652/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eEffective handover communication is a core professional competency in graduate medical education, yet very few junior doctors working in surgery receive formal training. A structured curriculum was developed and piloted to teach best practices in surgical handover, based on a recognised curricular framework.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out at two academic tertiary hospitals in Dublin, Ireland. Interns attending mandatory weekly teaching sessions participated in a 60-minute intervention combining didactic teaching, video demonstration, small group simulation, and facilitated discussion. Self-reported confidence in delivering and participating in handover was assessed using pre- and post-session surveys. Post-session feedback on curriculum content and format was also collected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA total of 59 interns attended the teaching sessions, with 35 providing paired pre- and post-session data. Self-reported confidence significantly improved across all assessed domains assessed (p\u0026lt;0.001), including confidence in handing over to peers and senior colleagues, asking clarifying questions during handover, and providing a summary or ‘readback’ at the end of handover. Feedback from 46 participants indicated that the session was well-received, with video demonstrations and simulated practice rated most helpful. Didactic teaching and peer feedback were rated least helpful. A majority (76.1%; n=35) reported that the session would lead to changes in their handover practice.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis pilot study demonstrated that a simulation-based curriculum is effective in improving interns’ self-reported confidence in delivering and receiving surgical handover. The teaching session was well-received, easily integrated into existing institutional infrastructure, and required minimal resources to carry out.\u003c/p\u003e","manuscriptTitle":"Development and pilot evaluation of a structured curriculum for surgical handover","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-24 16:49:56","doi":"10.21203/rs.3.rs-6777652/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-06T07:00:14+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-02T23:13:45+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-16T18:09:03+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"89290348882240227545498411058624678463","date":"2025-07-11T21:33:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"164357339651080173797657756188055245428","date":"2025-07-10T20:26:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"15155204555664935974841333969062130836","date":"2025-07-10T12:45:15+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-06-12T19:49:35+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-12T19:47:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-06-11T12:30:43+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-11T12:08:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2025-06-11T12:05:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2cd41f98-9ddb-45c8-8998-bb87de55edad","owner":[],"postedDate":"June 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T16:22:19+00:00","versionOfRecord":{"articleIdentity":"rs-6777652","link":"https://doi.org/10.1186/s12909-025-08044-3","journal":{"identity":"bmc-medical-education","isVorOnly":false,"title":"BMC Medical Education"},"publishedOn":"2025-10-22 16:16:13","publishedOnDateReadable":"October 22nd, 2025"},"versionCreatedAt":"2025-06-24 16:49:56","video":"","vorDoi":"10.1186/s12909-025-08044-3","vorDoiUrl":"https://doi.org/10.1186/s12909-025-08044-3","workflowStages":[]},"version":"v1","identity":"rs-6777652","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6777652","identity":"rs-6777652","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}