Background: Learner Handover (LH) is a practice in which student evaluations from one clinical rotation are shared with the director of the subsequent rotations. As Competency-Based Medical Education becomes a central model for medical education in North America, there has been an increasing emphasis on supporting medical trainees through a continuum of learning. As such, LH has been positioned as having potential benefit for longitudinal skills development. However, there has been limited formal implementation of LH within medical schools, owing to concerns around bias, stigma, and confidentiality. Current literature on LH focuses on attitudes of medical educators, with no known literature on student attitudes towards LH. Objective: This study aims to explore the perspectives of medical students and educators on LH in undergraduate medical education. Design/Methods: An anonymous online survey was distributed to medical students and educators at the University of Toronto. Multiple choice and Likert-scale questions assessed perceptions around LH. Open-ended questions explored respondents’ views around the primary goals for LH, student involvement within LH, considerations for optimizing LH, and attitudes towards different proposed LH models. Data was analyzed using a mixed model, with quantitative data studied utilizing descriptive statistics, and qualitative data summarized via inductive thematic analysis using NVivo 12. Results: 177 learners and 40 educators completed the survey. Most participants highlighted early identification of students in difficulty (56% students, 93% educators) and individualized learning support (58% students, 70% educators) as benefits to LH. Both groups identified concerns around introduction of bias (90% students, 93% educators) and stigmatization (81% students, 75% educators). Qualitative data emphasized concerns around bias and stigma, confidentiality, and learner anxiety. Participants identified the importance of ensuring transparency, prioritizing student participation, and building support systems as key elements to optimizing the LH process.
Conclusion(s): With the implementation of Competency-Based Medical Education, the debate around LH is especially relevant. This study demonstrates that despite perceived benefits of LH, there are several concerns that must be considered prior to formal implementation of a LH policy. Understanding both learner and educator perspectives is essential in guiding the successful development of LH.
