Development and implementation of an oral sign-out skills curriculum

J Gen Intern Med. 2007 Oct;22(10):1470-4. doi: 10.1007/s11606-007-0331-0. Epub 2007 Aug 3.


Introduction: Imperfect sign-out of patient information between providers has been shown to contribute to medical error, but there are no standardized curricula to teach sign-out skills. At our institution, we identified several deficiencies in skills and a lack of any existing training.

Aim: To develop a sign-out curriculum for medical house staff.

Setting: Internal medicine residency program.

Program description: We developed a 1-h curriculum and implemented it in August of 2006 at three hospital sites. Teaching strategies included facilitated discussion, modeling, and observed individual practice with feedback. We emphasized interactive communication, a structured sign-out format summarized by an easy-to-remember mnemonic ("SIGNOUT"), consistent inclusion of key content items such as anticipatory guidance, and use of concrete language.

Program evaluation: We received 34 evaluations. The mean score for the course was 4.44 +/- 0.61 on a 1-5 scale. Perceived usefulness of the structured oral communication format was 4.46 +/- 0.78. Participants rated their comfort with providing oral sign-out significantly higher after the session than before (3.27 +/- 1.0 before vs. 3.94 +/- 0.90 after; p < .001).

Discussion: We developed an oral sign-out curriculum that was brief, structured, and well received by participants. Further study is necessary to determine the long-term impact of the curriculum.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Communication*
  • Curriculum*
  • Education, Medical, Graduate / methods
  • Female
  • Humans
  • Internal Medicine / education*
  • Internship and Residency
  • Interprofessional Relations
  • Male
  • Physician-Patient Relations*
  • Sensitivity and Specificity
  • Total Quality Management