Answer to "What theory underpins handover education?"


Handover performance can be improved through structured and evidence-based education. Unfortunately, a proportion of handover education interventions fail to demonstrate theoretical and pedagogical frameworks and demonstrate significant variability in the delivery of education and method of assessment.


A previously published model describes three pillars of handover education represent a significant theoretical tool in the development of education. The constituent theories of egocentric heuristic, agency theory and coordination have implications for education design, delivery and assessment. Additionally, Gagne’s nine events of instruction presents a useful framework in which to develop an effective learning process. 


A general model of learning non-technical skills, the SECTORS model, has also been applied to the handover context to guide educational design. This model links the elements of Systems and technology use, Error awareness, Communication and Teamwork skills. It describes through Observation and simulation focused pedagogy higher level personal analytical skills of Risk assessment and Situational awareness)


Darbyshire, D., Gordon, M. and Baker, P. (2013) ‘Teaching handover of care to medical students’, The Clinical Teacher, 10(1), pp. 32–37.

Gagne, R. M. (1970) The conditions of learning, 2nd ed. Oxford, England: Holt, Rinehart & Winston (The conditions of learning, 2nd ed).

Gordon, M., Hill, E., Stojan, J. N. and Daniel, M. (2018) ‘Educational Interventions to Improve Handover in Health Care: An Updated Systematic Review’, Academic Medicine, 93(8), pp. 1234–1244.

Gordon, M., Box, H., Farrell, M. and Stewrt, A. (2015) ‘Non-technical skills learning in healthcare through simulation education: integrating the SECTORS learning model and complexity theory’, BMJ Simulation and Technology Enhanced Learning, 1(2), pp. 67–70.

Junior Doctors Committee (2015) Safe handover: safe patients. Guidance on clinical handover for clinicians and managers. Available at: (Accessed: 12 March 2019).

WHO (2007) ‘Communication During Patient Hand-Overs’. World Health Organisation. Available at: (Accessed: 12 March 2019).

© 2019 AMEE