IMPROVING HANDOFF BY DELIBERATE COGNITIVE PROCESSING: RESULTS FROM A RANDOMIZED-CONTROLLED EXPERIMENTAL STUDY

Abstract Background : While several interventions have been implemented successfully, handoff remains a vulnerable process because it relies on human memory. The aim of this study was to investigate the effect of deliberate cognitive processing (i.e. analytical, conscious and effortful thinking) on recall of information. Methods : Pediatric residents participated in a 2-phased randomized experiment. In phase 1, participants received written handoffs. One group reviewed the handoffs with the understanding that content specific questions about it would be asked later. The intervention group was also asked to develop a contingency plan, with the purpose to deliberately process the information. In phase 2, all participants were asked to recall all information about the received handoffs. Recall reports were analyzed. Outcome parameters were percentage and accuracy of reported idea units (single information elements) and inferences (conclusions computed by the participants based on two or more idea units). Results : Participants in the deliberate cognitive processing group, recalled significantly more inferences (7.24 vs 3.22) but fewer correct idea units (21.1 % vs 25.3%) than in the control group. There was no difference with regards to incorrectly recalled information. Conclusions : Our study revealed that deliberate cognitive processing leads to creation of more correct inferences, but fewer reported correct idea units. This suggests that deliberate cognitive processing results in interpretation of the information into higher level concepts, rather than remembering specific pieces of information separately. This implies better understanding of patients’ problems.