690 - A Thematic Analysis of Learner Handover Forms Completed by Graduating Residents Transitioning to Fellowship

Publication Number: 2673.690

Mollie Wasserman, Boston Children's Hospital, Boston, MA, United States; Debra Boyer, Nationwide Children's Hospital, Columbus, OH, United States; Michael Fishman, Boston Children's Hospital, Roslindale, MA, United States; Brian Lurie, Hasbro Children's Hospital at Rhode Island Hospital, Providence, RI, United States; Katherine Mason, The Warren Alpert Medical School of Brown University, Providence, RI, United States; Elisa Phillips, Stanford University School of Medicine, Palo Alto, CA, United States; Caroline Rassbach, Stanford University School of Medicine, Palo Alto, CA, United States; Daniel Schumacher, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Daniel Sklansky, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States; Brad Sobolewski, Cincinnati Children's, Cincinnati, OH, United States; Claire Stewart, Nationwide Children's Hospital, Columbus, OH, United States; Lara Stone, Cincinnati Children's Hospital Medical Center, Maineville, OH, United States; Ariel Winn, Boston Children's Hospital, Concord, MA, United States; Laura Chiel, Boston Children's Hospital, Boston, MA, United States

Background: The residency to fellowship transition is characterized by a tension between trainees' increased clinical responsibility without commensurate subspecialty skills leading to heightened trainee vulnerability, often without a formalized opportunity for self-reflection. To support this transition, a learner handover process was piloted, during which graduating residents complete a form about their strengths, goals and concerns prior to starting fellowship, and review and optionally edit this form with a residency program leader before it is sent to the fellowship program director (Figure).

Objective: This study aims to characterize the types of information included on the learner education handover forms during the pilot.

Design/Methods: Graduating residents at five pediatric residency programs were invited to participate in a Learner Education Handover (LEH) pilot between January-June 2025, with 24 total residents opting in across all sites. The process, developed with broad stakeholder input, included a handover tool, consisting of a residency program description and a form completed by graduating residents, that was reviewed by the resident and residency program leader and sent to the fellowship program director (Figure). We completed an inductive thematic analysis of a sample of twelve LEH forms completed as part of this pilot implementation. This study was deemed exempt from review by the Institutional Review Board.

Results: Three major themes resulted from analysis of the handover forms. The handover forms included: (1) descriptions of both preparedness from residency and areas requiring development in the fellow role, including educational and consultation responsibilities; (2) reflections on clinical strengths alongside identified subspecialty clinical skills to develop in fellowship; and (3) unique personal and professional interests to pursue during fellowship.

Conclusion(s): The LEH forms characterize the transition to fellowship as a period of both readiness and growth, with focus on graduating residents' professional identity, clinical skillset and unique interests. The LEH form captures important insights into learners' strengths, learning needs, and concerns, shedding insight into salient issues at this transition and offering fellowship programs a structured way to support individualized development during this key career transition.

Figure
Learner education handover (LEH) form utilized during the pilot LEH from residency to fellowship.