Original Contribution Simulation-based education with deliberate practice may improve intraoperative handoff skills: a pilot study Erin W. Pukenas MD, FAAP (Assistant Professor of Anesthesiology) a, ⁎ , Gregory Dodson DO (Chief Resident) a , Edward R. Deal DO (Assistant Professor of Anesthesiology) a , Irwin Gratz DO (Professor of Anesthesiology) a , Elaine Allen PhD (Professor of Epidemiology Biostatistics) b , Amanda R. Burden MD (Assistant Professor of Anesthesiology) a a Department of Anesthesiology, Cooper Medical School of Rowan University, One Cooper Plaza, Camden, NJ 08103, USA b Department of Epidemiology and Biostatistics, University of California, San Francisco, Box 0560 UCSF, San Francisco, CA, 94143-0560, USA Received 13 November 2012; revised 10 March 2014; accepted 11 March 2014 Keywords: Anesthesiologists; Deliberate practice; Handoff education; Intraoperative communication; Residency training; Simulation Abstract Study Objective: To examine the results of simulation-based education with deliberate practice on the acquisition of handoff skills by studying resident intraoperative handoff communication performances. Design: Preinvention and postintervention pilot study. Setting: Simulated operating room of a university-affiliated hospital. Measurements: Resident handoff performances during 27 encounters simulating elective surgery were studied. Ten residents (CA-1, CA-2, and CA-3) participated in a one-day simulation-based handoff course. Each resident repeated simulated handoffs to deliberately practice with an intraoperative handoff checklist. One year later, 7 of the 10 residents participated in simulated intraoperative handoffs. All handoffs were videotaped and later scored for accuracy by trained raters. A handoff assessment tool was used to characterize the type and frequency of communication failures. The percentage of handoff errors and omissions were compared before simulation and postsimulation-based education with deliberate practice and at one year following the course. Main Results: Initially, the overall communication failure rate, defined as the percentage of handoff omissions plus errors, was 29.7%. After deliberate practice with the intraoperative handoff checklist, the communication failure rate decreased to 16.8%, and decreased further to 13.2% one year after the course. Conclusions: Simulation-based education using deliberate practice may result in improved intraoperative handoff communication and retention of skills at one year. © 2014 Elsevier Inc. All rights reserved. ⁎ Correspondence: Erin W. Pukenas, MD, Assistant Professor of Anesthesiology, Cooper University Hospital, Department of Anesthesiology One Cooper Plaza, Camden, NJ 08103, USA. Tel.: +1-856-968-7334; fax: +1-856-968-9554. E-mail address: pukenas@rowan.edu (E.W. Pukenas). http://dx.doi.org/10.1016/j.jclinane.2014.03.015 0952-8180/© 2014 Elsevier Inc. All rights reserved. Journal of Clinical Anesthesia (2014) 26, 530–538