Susan Humphrey-Murto¹
Julie D'Aoust¹, Samantha Halman¹, Tammy Shaw¹, Vijay Daniels², Lynfa Stroud³, Alice Yu¹, Irene Ma⁴, Beth-Ann Cummings⁵ and Timothy J. Wood¹
1 University of Ottawa
2 University of Alberta
3 University of Toronto
4 University of Calgary
5 McGill University

Learner Education Handover (LEH) is the sharing of information about learners between faculty supervisors. Previous studies demonstrate LEH biased scores after viewing a single performance.1 In the workplace, however, faculty supervisors often have multiple interactions with learners. It is unknown if LEH bias diminishes after several observations. Question: Does LEH influence faculty ratings, entrustment decisions and feedback after observing several performances of the same learner? 

Internal medicine faculty members (n=57) from five medical schools were randomly assigned to one of three study groups. Each group received either positive, negative or no LEH prior to watching five simulated resident-patient encounter videos of the same resident. Participants rated each video using the mini-CEX (5 items /global rating), an entrustment scale and provided written feedback. Feedback was assigned a valence score (-3 to +3). 

For most videos, there was no difference in mean mini-CEX, entrustment scores or feedback between the study groups (positive LEH, negative LEH, control). Differences were found for: video 1, the feedback valence was higher in the positive LEH (0.79) compared to control group (-0.53, p<.001) and for video 4 the control group means for mini-CEX global rating and entrustment scores were unexpectedly lower compared to the negative condition (4.68 vs 5.84, p =.04; 2.79 vs 3.47, p =.02) 

In the post-study questionnaire, most raters reported the LEH had minimal effect on their decisions, but that they might be influenced more on the first compared to the last video. Only 29% of raters guessed the true purpose of the study. 

Contrary to previous studies, our results demonstrate minimal effect of LEH on scores or feedback by faculty after one encounter.2 No effect of LEH was seen over the subsequent four encounters of the same resident. These results may help alleviate some of the concerns surrounding LEH practices.3 

References (maximum three) 

1. Shaw T, Wood TJ, Touchie T, Pugh D, Humphrey-Murto S. How biased are you? The effect of Prior Performance Information on Attending Physician Ratings and Implications for Learner Handover. Adv Health Sci Educ Theory Pract. 2021 Mar;26(1):199-214. 

2. Humphrey-Murto S, LeBlanc A, Touchie C, Pugh D, Wood TJ, Cowley L, Shaw T. The Influence of Prior Performance Information on Ratings of Current Performance and Implications for Learner Handover: A Scoping Review. Acad Med. 2019 Jul;94(7):1050-1057. 

3. Kassam A, Ruetalo M, Topps M, et al. Key stakeholder opinions for a national learner education handover. BMC Med Educ. 2019;19(1):150.