Measured and perceived handover effectiveness among nurse, paramedic and medical students


  • Amanda Hlushak Charles Sturt University
  • Alexander MacQuarrie Charles Sturt University, Bathurst, Australia
  • Clare Sutton Charles Sturt University, Bathurst, Australia
  • Georgina Pickering Charles Sturt University, Bathurst, Australia
  • Patricia Logan Charles Sturt University, Bathurst, Australia
  • Caroline Robertson Western Sydney University, Bathurst, Australia


Objective: This study aimed to measure the effectiveness of student handovers in simulation and examine perceptions of handover effectiveness.

Methods: A mixed-methods crossover study involving interprofessional teams of nursing students (NS), paramedic students (PS) and medical students (MS). Students participated in two medical clinical simulations, which involved handovers, completion of self-reflection questionnaires (SRQ) and pre-post simulation questionnaires: Readiness for Interprofessional Learning Scale (RIPLS) and Attitudes Towards Health Care Teams Scale (ATHCT).

Results: 18 handovers were observed. Outbound simulation (n=9): 61% of all data items were transferred by the MS, 60% by NS, and 63% by PS. Inbound simulation (n=9): 80% of all data items were transferred by PS, 64% by NS and 50% by MS. Information handed over was most variable when broken down into categories. Data most likely to be handed over were patient demographics, clinical impression and treatment. Least likely to be handed over were additional background and response to treatment. The RIPLS questionnaire showed significant differences between student groups and a change in score between pre-post questionnaires, with NS and PS scoring higher than MS: 6.33 ± 3.51, 4.71 ± 4.37 and -2.67 ± 2.3, respectively (p < 0.05). No differences were noted between the pre- and post-ATHCT questionnaire. Comparison of actual and perceived data transferred showed the percentage of non-clinical data actually transferred to be higher than students’ perceived (p < 0.05).

Conclusion: In simulation, a significant amount of critical patient information was lost in subsequent handovers. The greatest loss of data occurred from additional background information and response to treatment. There was also an imbalance between students’ perceptions of, and actual, data transferred. Our results indicate that students require increased opportunities for handover practice and clarification on what constitutes an accurate handover. Amalgamation of current handover tools to a single tool that can be used in pre-hospital and hospital environments may be beneficial.

Article submitted: 8/11/2018

Article accepted: 6/12/2018

Publish date: 17/12/2018


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Author Biography

Amanda Hlushak, Charles Sturt University

Amanda Hlushak is a current academic in the Bachelor of Clinical Practice-Paramedic Program at Charles Sturt University.  She is a current practicing paramedic in NSW Ambulance service.

She has completed her Master of Health Science and Master of Paramedic Practitioner.

Amanda's research interests include education and clinical skill development, such as handovers.


Abraham, J, Kannampallil, T & Patel, VL 2014, ‘A systematic review of the literature on the evaluation of handoff tools: implications for research and practice’, Journal of the American Medical Informatics Association, vol. 21, pp. 154–162.

Angelini, DJ 2011, ‘Interdisciplinary and interprofessional education: What are the key issues and considerations for the future? The Journal of Perinatal and Neonatal Nursing, vol. 25, pp. 175–179.

Berkenstadt, H, Haviv, Y, Tuval, A, Shemesh, Y, Megrill, A, Perry, A, Rubin, O & Ziv, A 2008, ‘Improving Handoff Communications in Critical Care: Utilizing Simulation-Based Training Toward Process Improvement in Managing Patient Risk’, Chest, vol. 134, pp. 158–162.

Bost, N, Crilly, J, Patterson, E & Chaboyer, W 2012, ‘Clinical handover of patients arriving by ambulance to a hospital emergency department: A qualitative study’, International Emergency Nursing, vol. 20, pp. 133–141.

Bridges, DR & Tomkowiak, J 2010, ‘Allport's intergroup contact theory as a theoretical base for impacting student attitudes in interprofessional education’. Journal of Allied Health [Online], 39. https://search-proquest-

Drach‐Zahavy, A, Goldblatt, H & Maizel, A 2015, ‘Between standardisation and resilience: nurses' emergent risk management strategies during handovers’, Journal of Clinical Nursing, vol. 24, pp. 592–601.

Evans, SM, Murray, A, Patrick, I, Fitzgerald, M, Smith, S, Andrianopoulos, N & Cameron, P 2010, ‘Assessing clinical handover between paramedics and the trauma team’, Injury, vol. 41, pp. 460–464.

Fitzpatrick, D, Mckenna, M, Duncan, EAS, Laird, C, Lyon, R & Corfield, A 2018, ‘Critcomms: a national cross-sectional questionnaire based study to investigate prehospital handover practices between ambulance clinicians and specialist prehospital teams in Scotland’, Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, vol. 26, p. 45.

Foronda, C, MacWilliams, B & McArthur, E 2016, ‘Interprofessional communication in healthcare: An integrative review’, Nurse Education in Practice, vol. 19, pp. 36–40.

Furseth, AP, Taylor, CB & Kim, CS 2016, ‘Impact of interprofessional education among nursing and paramedic students’, Nurse Educator, vol. 41, pp. 75–79.

Gierman-Riblon, C & Salloway, S 2013, ‘Teaching Interprofessionalism to nursing students: a learning experience based on Allport’s intergroup contact theory’, Nursing Education Perspectives, vol. 34, pp. 59–62.

Gordon, M & Findley, R 2011, ‘Educational interventions to improve handover in health care: a systematic review’, Medical Education, vol. 45, pp. 1081–1089.

Havrilla-Smithburger, P, Kane-Gill, S & Seybert, A 2012, ‘Use of high fidelity simulation for interprofessional education in an ICU environment’, Critical Care Medicine, vol. 40, U165–U165.

Jeffcott, SA, Evans, SM, Cameron, PA, Chin, GSM & Ibrahim, JE 2009, ‘Improving measurement in clinical handover’, Quality and Safety in Health Care, vol. 18, p. 272.

Kim, K & Ko, J 2014, ‘Attitudes toward interprofessional health care teams scale: a confirmatory factor analysis’, Journal of Interprofessional Care, vol. 28, pp. 149–154.

Koo, TK & Li, MY 2016, ‘A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research’, Journal of Chiropractic Medicine, vol. 15, pp. 155–163.

Maharajan, MK, Rajiah, K, Khoo, SP, Chellappan, DK, De Alwis, R, Chui, HC, Tan, LL, Tan, YN. & Lau, SY 2017, ‘Attitudes and Readiness of Students of Healthcare Professions towards Interprofessional Learning’, PLoS One, vol. 12, e0168863.

Merten, H, Van Galen, LS & Wagner, C 2017, ‘Safe handover’, British Medical Journal, vol. 359; j4328.

Okitsu , H, Sawamura, J, Nishimura, K, Sato, Y & Ishigooka, J 2014, ‘A comparison of a patient-rated visual analogue scale with the Liebowitz Social Anxiety Scale for social anxiety disorder: A cross-sectional study’, Journal of Psychiatry, vol. 4, pp. 68–74.

Patterson, ES & Wears, RL 2010, ‘Patient Handoffs: Standardized and Reliable Measurement Tools Remain Elusive’, The Joint Commission Journal on Quality and Patient Safety, vol. 36, pp. 52–61.

Reid, R, Bruce, D, Allstaff, K & Mclernon, D 2006, ‘Validating the Readiness for Interprofessional Learning Scale (RIPLS) in the postgraduate context: are health care professionals ready for IPL?’ Medical Education, vol. 40, pp. 415–422.

Starmer, AJ & Landrigan, CP 2015, ‘Changes in medical errors with a handoff program’, New England Journal of Medicine, vol. 372, pp. 490–1.

Starmer, AJ, Spector, ND, Srivastava, R, West, DC, Rosenbluth, G, Allen, AD, Noble, EL, Tse, LL, Dalal, AK, Keohane, CA, Lipsitz, SR, Rothschild, JM, Wien, MF, Yoon, CS, Zigmont, KR, Wilson, KM, O'Toole, JK, Solan, LG, Aylor, M, Bismilla, Z, Coffey, M, Mahant, S, Blankenburg, RL, Destino, LA, Everhart, JL, Patel, SJ, Bale, JF Jr, Spackman, JB, Stevenson, AT, Calaman, S, Cole, FS, Balmer, DF, Hepps, JH, Lopreiato, JO, Yu, CE, Sectish, TC & Landrigan, CP 2014, ‘Changes in medical errors after implementation of a handoff program’, New England Journal of Medicine, vol. 371, pp. 1803–12.

Stow, J, Morphet, J, Griffiths, D, Huggins, C & Morgan, P 2017, ‘Lessons learned developing and piloting interprofessional handover simulations for paramedic, nursing, and physiotherapy students’, Journal of Interprofessional Care, vol. 31, pp. 132–135.

Thakore, S & Morrison, W 2001, ‘A survey of the perceived quality of patient handover by ambulance staff in the resuscitation room’, Emergency Medicine Journal, vol. 18, pp. 293–296.

Thoureen, TL & Scott, SB 2013, Emergency medicine simulation workbook: a tool for bringing the curriculum to life, Wiley-Blackwell, Chichester, West Sussex.

Tunstall-Pedoe, S, Rink, E & Hilton, S 2003, ‘Student attitudes to undergraduate interprofessional education’, Journal of Interprofessional Care, vol. 17, pp. 161–72.

Weller, J 2012, ‘Shedding new light on tribalism in health care’, Medical Education, vol. 46, pp. 134–6.

Wood, K, Crouch, R, Rowland, E & Pope, C 2015, ‘Clinical handovers between prehospital and hospital staff: literature review’, Emergency Medical Journal, vol. 32, pp. 577.

Ye, K, McD Taylor, D, Knott, JC, Dent, A & MacBean, CE 2007, Handover in the emergency department: Deficiencies and adverse effects’, Emergency Medicine Australasia, vol. 19, pp. 433–441.

Yong, G, Dent, AW & Weiland, TJ 2008, ‘Handover from paramedics: Observations and emergency department clinician perceptions’, Emergency Medicine Australasia, vol. 20, pp. 149–155.

Yu, M & Kang, KJ 2017, ‘Effectiveness of a role-play simulation program involving the SBAR technique: A quasi-experimental study’, Nurse Education Today, vol. 53, pp. 41–47.




How to Cite

Hlushak, A., MacQuarrie, A., Sutton, C., Pickering, G., Logan, P., & Robertson, C. (2018). Measured and perceived handover effectiveness among nurse, paramedic and medical students. ealth ducation in ractice: ournal of esearch for rofessional earning, 1(2). etrieved from