How to Hand Over Effectively in the Internal Medicine Training (IMT) Interview: A Guide Using SBARD

One of the most critical skills assessed in the Internal Medicine Training (IMT) interview is your ability to communicate effectively. ‘Patient handover’ is the 2nd part of the Clinical Scenario when you will be asked to do a one-minute handover of the patient to a colleague. This will require you to speak for up to one minute as if you were speaking to the person being given the handover.

A well-structured handover demonstrates your ability to prioritize, think critically, and ensure patient safety. The SBARD framework (Situation, Background, Assessment, Recommendation, Decision) is an excellent tool recommended by Resuscitation Council UK to structure your handover, and mastering it can help you secure a high score in this part of the interview.

Here’s how to use SBARD effectively in your IMT interview:

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Introduction:

You should introduce yourself before starting SBARD. Therefore say something like: ‘Hello, I am one of the Internal medicine Trainees’ or maybe ‘Hello, I am the medical SHO on-call’

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S: Situation

The first step is to clearly describe the current situation. Provide concise but specific details to set the stage for your handover:

• Patient’s age and gender
• Working diagnosis based on your findings
• The presenting complaint, described precisely (Let’s say, the question says chest pain. Dont just say chest pain. Instead add the information you’ve gathered as well. For example, instead of saying ‘chest pain’ say ‘Left sided pleuritic chest pain’)

Eg: I have a 56-year-old male with a working diagnosis of Pulmoary Embolism who presented with sudden onset left-sided pleuritic chest pain and shortness of breath

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B: Background

Next, provide the patient’s relevant past medical history. Key Elements to Include:

• Relevant past medical history
• anything else that is mentioned in the question/you’ve found out from your assessment which is relevant (ie: allergic history)

Tips:
Keep it brief and relevant to the current problem. Avoid overloading with unnecessary details unless specifically asked.

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A: Assessment

Share the findings from your assessments and actions systematically, focusing on the positives. Use the A to E approach for clarity. Key Elements to Include are:

• Positive findings form ABCDE assessment
• Relevant information from history
• Actions Taken: Mention what you’ve already done
• Mention the potential life threatening differntials that you have excluded

Eg: On examination, the patient was hypoxic, tachycardic, therefore we have given oxygen, rest of the examination and examination findings were within normal range. He has negative troponin and non-dynamic ECG changes which excluded ACS, and normal CXR which excludes Pneumothorax and CAP.

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R: Recommendation

• What you believe needs to be done next (e.g: I recommend starting therapeutic anticoagulation for suspected pulmonary embolism after imaging”).
• Clearly state what you want the person you’re handing over to do.
• Mention any outstanding investigations or results (e.g., “Awaiting CTPA and troponins”).

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D: Decision

While time constraints might limit this step, aim to summarize and conclude effectively. If you don’t have time, avoid summarizing.

• Say that you will provide the details of the patient
• And finish by asking if they require more information.

Eg: “I will provide the name, DOB amd hospital no/NHS No of this patient. Please let me know if there’s anything else you’d like to know about this patient or if you need further details. Thank you.”

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Repetition is the key to mastery. Practice, practice and practice!

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Tags: Career in the UK, Clinical Handover, Doctor, Faisal Abdullah, Faisalization, Handover, IMT, IMT Interview, IMT Interview Preparation, Internal Medicine Training, NHS