Available online 26 May 2025

The impact of intern involvement in surgical handover is poorly understood.

Interns who were fully involved in morning handover showed evidence of learning.

They were also more likely to respond to daily patient care queries immediately.

Reduced intern involvement in handover has the potential to delay patient care.

Surgical handover is a key risk area in patient care, yet the impact of junior team member involvement in the process is not well understood. This study aims to assess the level of intern involvement in emergency general surgery (EGS) handover and its impact on daily tasks.

Overt, structured, non-participant observations of morning EGS handover meetings were carried out to assess intern involvement. The same interns were then observed over the course of the day-shift immediately following the handover. During these observation periods, details of all patient care queries addressed to the interns were recorded.

Five general surgery interns (42%) were observed across six EGS handover meetings. A total of 100 clinical queries were recorded during 25 h of observation. Only 2/6 handover meetings had full intern involvement. While all appeared to be actively listening during handover, questions were asked, and readbacks were provided by interns during 4/6 and 3/6 handovers, respectively. Clinical queries directed at interns who were fully involved in the morning handover were more likely to be answered immediately (96.6 %,n = 29 vs. 78.6 %,n = 55; p = 0.024) and using memory of the verbal handover (50 %,n = 15 vs 24.3 %,n = 17; p = 0.012). One incidence of negligible harm occurred, due to omission of a patient's allergy information from the handover.

Interns who are fully involved in handover show evidence of learning and are more likely to respond to queries faster and from memory. Reduced involvement in the post-call handover process has the potential to delay, and therefore negatively impact, patient care.

Surgical handover

Medical education

Quality

Continuity of care

Healthcare improvement

© 2025 The Authors. Published by Elsevier Ltd on behalf of Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland.