Appendix N: Rotation One-Pagers: A Template and AI Drafting Prompt for Residents
A rotation one-pager is a single page that tells an incoming resident what the outgoing resident wishes someone had told them: who to call, what the day looks like, where things live in the electronic health record (EHR), and what the attendings expect. It replaces nothing official. It sits next to the program’s orientation materials and points to them.
- Use the template below to write one page per rotation. Fill it with local details only you and your co-residents know.
- An institution-approved AI tool can turn old slide decks and scattered notes into a first draft. The drafting prompt below is ready to paste.
- Never paste patient information into the tool. Check every clinical fact against the source it came from. The outgoing resident and the chief resident review the page before it is shared.
- The page is a draft guide. Departmental policy, the attending, and the order sets remain the authority.
- The three examples are illustrative templates written for this handbook. They are not from any residency program.
Why One Page
Orientation decks often run long and mix policy, history, and logistics. The details that matter on day one get lost: which pager to answer first, where the handoff list is kept, and which consults need a call instead of an order. One page forces a choice about what matters most.
No trial has tested rotation guides. The closest evidence comes from resident handoffs. In a prospective study across nine hospitals, a handoff program that standardized oral and written handoffs, together with training and faculty observation, was associated with a 23% lower medical-error rate (24.5 vs. 18.8 per 100 admissions) and a 30% lower rate of preventable adverse events, without longer oral handoffs (Starmer et al., 2014). That study tested a structured handoff program, not orientation documents. It supports the idea that a shared, structured format helps key details reach the next person. It does not show that a rotation one-pager improves patient outcomes.
The Rotation One-Pager Template
Copy the template into a document. Replace each bracketed item. Delete any row that does not apply. If a section runs long, link to the official document instead of copying it.
ROTATION ONE-PAGER: [Rotation name] at [Site]
Last reviewed: [Month Year] by [Outgoing resident] and [Chief resident]
Official orientation materials: [Link or location]
WHO TO CALL
- Senior or supervising resident: [How to reach]
- Attending on service: [How to reach; when they want a call]
- Charge nurse: [Unit phone]
- Pharmacy: [Number]
- Consult services you call most: [Service: how to reach]
- After hours and backup: [Who covers; how to escalate]
THE DAY
- Arrive: [Time and place]
- Pre-rounding: [What to do before rounds]
- Rounds: [Time, place, format]
- Conferences or protected time: [When]
- Sign-out: [Time, place, handoff format your program uses]
WHAT IS EXPECTED OF YOU
- Notes: [Which notes, by when]
- Orders and discharges: [Who does what; deadlines]
- Patient census: [Typical range and cap, per program policy]
- Presenting on rounds: [Format attendings on this service prefer]
COMMON PAGES AND CONSULTS
- [Page type]: [First steps; who to tell; link to the unit protocol]
- [Consult]: [How to request; what to have ready]
WHERE THINGS LIVE IN THE EHR
- Patient list or handoff tool: [Location]
- Order sets the service uses: [Names]
- Note templates: [Names]
- Unit protocols and policies: [Location]
PITFALLS
- [Something that trips up new residents and how to avoid it]
WHAT ATTENDINGS WANT
- [Preferences that are stable across attendings on this service]
LEARNING RESOURCES
- [Core references the service uses; departmental guidelines]
NOT IN THIS GUIDE
- Drug doses, clinical thresholds, and protocols. Use the order sets,
pharmacy, and the official unit protocols.Drafting the Page with an AI Tool
Most of the work in a one-pager is sorting: pulling the few useful lines out of a long deck, an old email, and a shared notes file. A large language model can do that sorting quickly. It can also invent a phone number, a policy, or a clinical threshold that looks right and is wrong. The Physician AI Handbook covers these failure modes in Large Language Models in Clinical Practice.
Guardrails Before You Start
Use only an AI tool your institution has approved for this kind of work, and follow your institution’s AI and privacy policies. Consumer chatbots may store what you paste. The privacy issues are covered in Privacy, HIPAA, and Legal Considerations.
- No patient information. Remove names, record numbers, dates of service, and any detail that could identify a patient before you paste anything. A rotation guide needs no patient data.
- No clinical rules from the model. If the draft contains a dose, a lab threshold, or a protocol step, delete it or replace it with a pointer to the official source.
- Verify every fact. Check each phone number, location, time, and policy against its source. Mark anything you could not check.
- Two human reviewers. The outgoing resident and the chief resident (or another person the program names) review the page before it is shared.
- Label it. The top of the page states who reviewed it and when.
- The page is a draft. Departmental policy, the attending, and the order sets remain the authority. If the page and the policy disagree, the policy wins and the page gets fixed.
The Drafting Prompt
Paste the prompt into the approved tool, then paste your source material under it. Good source material includes the official orientation deck, departmental emails about the rotation, and notes from residents who just finished it, with all patient information removed.
You are helping a resident write a one-page orientation guide for the
next resident on a rotation. Use only the source material I paste below.
Rules:
1. Do not add any fact that is not in the source material. If a section
has no source material, write "[Not in sources: ask outgoing resident]".
2. Do not include drug doses, lab thresholds, scoring cutoffs, or
protocol steps. Where the sources mention them, write
"[See official protocol: name of document]" instead.
3. Do not include any patient information. If you see any, stop and
tell me which line contains it.
4. Keep the whole guide to one printed page. Use short bullet points.
5. Use these headings in this order: Who to Call, The Day, What Is
Expected of You, Common Pages and Consults, Where Things Live in the
EHR, Pitfalls, What Attendings Want, Learning Resources.
6. After the guide, list every fact you included with the sentence from
the source material that supports it, so I can check each one.
7. List any conflicts between sources separately. Do not resolve them.
Rotation: [Rotation name]
Site: [Site]
Source material:
[Paste here]Step 6 of the prompt makes checking faster. It does not replace checking: models can attach a real sentence to a claim it does not support.
Passing the Page Down
Store the page where the program keeps rotation materials, with the review date at the top. At the end of each block, the outgoing resident spends a few minutes on it: delete what changed, add one pitfall, and update the review line. A chief resident or program coordinator can own the folder so pages do not drift out of date.
Three Illustrative Examples
These three examples were written for this handbook to show the format. They are not resident-written, and they do not describe any real program, hospital, or service. Bracketed items are local details to fill in. The examples contain no clinical thresholds or doses on purpose; those belong in your institution’s protocols.
Example 1: Inpatient Medicine Wards
ROTATION ONE-PAGER: Inpatient Medicine Wards at [Hospital]
Last reviewed: [Month Year] by [Outgoing resident] and [Chief resident]
Official orientation materials: [Link]
WHO TO CALL
- Senior resident: [Team pager]. Call for any new admission, any
patient you are worried about, and any family meeting.
- Attending: [How to reach]. Ask on day one which events they want a
call for (for example, transfers to a higher level of care, deaths,
and patients leaving against medical advice).
- Charge nurse: [Unit phone]. Case management: [Extension].
THE DAY
- [Time]: pre-round on your patients; read overnight events first.
- [Time]: team rounds at [place].
- [Time]: noon conference (protected unless a patient is unstable).
- [Time]: afternoon work, discharges, family updates.
- [Time]: sign-out to the night team in [place], using the program's
handoff format.
WHAT IS EXPECTED OF YOU
- Progress notes signed by [time]. Discharge summaries on the day of
discharge.
- Start discharge paperwork the day before an expected discharge.
- Present new patients in the format your attending asks for.
COMMON PAGES AND CONSULTS
- Nursing concern about a patient: see the patient, then tell your
senior. Use the rapid response criteria posted at [location].
- Consults: place the order in the EHR and call the consult team for
anything urgent. Have the question you want answered ready.
WHERE THINGS LIVE IN THE EHR
- Team list and handoff tool: [Location]
- Admission and discharge order sets: [Names]
PITFALLS
- Discharges stall when transport, medications, and follow-up are
arranged on the day of discharge. Start the day before.
- Overnight events are easy to miss. Read the night note first.
WHAT ATTENDINGS WANT
- A clear one-line summary and a plan for each problem.
- To hear about bad news from you first.
LEARNING RESOURCES
- [Departmental guidelines]; [core reference the service uses]Example 2: Night Float
ROTATION ONE-PAGER: Medicine Night Float at [Hospital]
Last reviewed: [Month Year] by [Outgoing resident] and [Chief resident]
Official orientation materials: [Link]
WHO TO CALL
- Night senior or supervising resident: [Pager]. Call for every
admission decision you are unsure about and every patient getting
worse.
- Night attending or hospitalist: [How to reach]. Program policy on
when to call: [Link].
- ICU team: [Pager]. Rapid response: [Number].
THE NIGHT
- [Time]: receive sign-out from each day team in [place]. Ask about
anything marked "watch" or "if-then".
- [Time]: run the list; see any patient flagged as sick first.
- Overnight: cross-cover pages and admissions.
- [Time]: write overnight events in [note type].
- [Time]: sign out to day teams in [place].
WHAT IS EXPECTED OF YOU
- Respond to pages within [time set by program].
- Document every overnight event that changed management.
- Admissions: complete the history, exam, and orders by [time].
COMMON PAGES
- New fever, low blood pressure, chest pain, change in mental status,
falls: see the patient. Use the unit protocols at [location] and tell
your senior.
- Medication questions: call the night pharmacist at [number].
WHERE THINGS LIVE IN THE EHR
- Cross-cover list: [Location]
- Event note template: [Name]
PITFALLS
- Vague sign-out leads to guessing at 3 a.m. Ask the day team what to
do if the patient changes.
- Double-check orders written late in the shift.
WHAT ATTENDINGS WANT
- A clear overnight summary at morning sign-out.
- A call when you are worried, at any hour.
LEARNING RESOURCES
- [Program's cross-cover curriculum]; [departmental guidelines]Example 3: Intensive Care Unit
ROTATION ONE-PAGER: Medical ICU at [Hospital]
Last reviewed: [Month Year] by [Outgoing resident] and [Chief resident]
Official orientation materials: [Link]
WHO TO CALL
- ICU fellow or senior: [Pager]. Call for every new admission, every
procedure, and any patient getting worse.
- ICU attending: [How to reach]. Unit call criteria: [Location].
- Respiratory therapy: [Number]. ICU pharmacist: [Number].
THE DAY
- [Time]: pre-round; review overnight events, ventilator settings,
drips, and lines with the nurse.
- [Time]: multidisciplinary rounds at [place].
- [Time]: family meetings as scheduled.
- [Time]: sign-out using the unit's handoff format.
WHAT IS EXPECTED OF YOU
- Know every line, drain, and drip on your patients and why each is
there.
- Notes signed by [time].
- Procedures only with the supervision level the program requires.
COMMON PAGES AND CONSULTS
- Any change in a patient's condition: tell the fellow or senior right
away, then follow the unit protocol.
- Family questions: offer a meeting with the team. Do not give a
prognosis on your own.
WHERE THINGS LIVE IN THE EHR
- ICU flowsheets and drip records: [Location]
- ICU order sets and protocols: [Names and location]
PITFALLS
- Lines and devices that are no longer needed stay in when no one asks.
Ask on rounds every day.
- Plans change quickly. Re-read the plan before you act on it.
WHAT ATTENDINGS WANT
- A systems-based presentation in the order the unit uses.
- Early warning when a patient is getting worse.
LEARNING RESOURCES
- [Unit protocols]; [departmental critical care curriculum]