Tyler J Albert1,2, Jeff Redinger3,4, Helene Starks3,5, Joel Bradley6,7, Craig G Gunderson8,9, Dan Heppe10,11, Kyle Kent12,13, Michael Krug3,14, Brian Kwan15,16, James Laudate6,7, Amanda Pensiero17,18, Gina Raymond19,20, Emily Sladek15,16, Joseph R Sweigart21, Paul B Cornia3,4. 1. Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. Tyler.Albert@va.gov. 2. VA Puget Sound Health Care System, Seattle, WA, USA. Tyler.Albert@va.gov. 3. Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA. 4. VA Puget Sound Health Care System, Seattle, WA, USA. 5. Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA. 6. Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA. 7. White River Junction VA Medical Center, Hartford, VT, USA. 8. Department of Medicine, Yale University School of Medicine, New Haven, CT, USA. 9. VA Connecticut Health Care System, West Haven, CT, USA. 10. Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA. 11. VA Eastern Colorado Health Care System, Aurora, CO, USA. 12. Department of Medicine, Oregon Health Sciences University, Portland, OR, USA. 13. Portland VA Medical Center, Portland, OR, USA. 14. Boise VA Medical Center, Boise, ID, USA. 15. Department of Medicine, University of San Diego School of Medicine, La Jolla, CA, USA. 16. San Diego VA Medical Center, San Diego, CA, USA. 17. Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 18. Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA. 19. Department of Medicine, University of Tennessee Health Sciences Center School of Medicine, Memphis, TN, USA. 20. Memphis VA Medical Center, Memphis, TN, USA. 21. Lexington VA Health System, Lexington, KY, USA.
Abstract
BACKGROUND: Residents rate morning report (MR) as an essential educational activity. Little contemporary evidence exists to guide medical educators on the optimal content or most effective delivery strategies, particularly in the era of resident duty-hour limitations and shifts towards learner-centric pedagogy in graduate medical education. OBJECTIVE: Assess resident views about MR content and teaching strategies. DESIGN: Anonymous, online survey. PARTICIPANTS: Internal medicine residents from 10 VA-affiliated residency programs. MAIN MEASURES: The 20-item survey included questions on demographics; frequency and reason for attending; opinions on who should attend, who should teach, and how to prioritize the teaching; and respondents' comfort level with participating in MR. The survey included a combination of Likert-style and multiple-choice questions with the option for multiple responses. KEY RESULTS: A total of 497 residents (46%) completed the survey, with a balanced sample of R1s (33%), R2s (35%), and R3s (31%). Self-reported MR attendance was high (31% always attend; 39% attend > 50% of the time), with clinical duties being the primary barrier to attendance (85%). Most respondents felt that medical students (89%), R1 (96%), and R2/R3s (96%) should attend MR; there was less consensus regarding including attendings (61%) or fellows (34%). Top-rated educational topics included demonstration of clinical reasoning (82%), evidence-based medicine (77%), and disease pathophysiology (53%). Respondents valued time spent on diagnostic work-up (94%), management (93%), and differential building (90%). Overall, 82% endorsed feeling comfortable speaking; fewer R1s reported comfort (76%) compared with R2s (87%) or R3s (83%, p = 0.018). Most (81%) endorsed that MR was an inclusive learning environment (81%), with no differences by level of training. CONCLUSIONS: MR remains a highly regarded, well-attended educational conference. Residents value high-quality cases that emphasize clinical reasoning, diagnosis, and management. A supportive, engaging learning environment with expert input and concise, evidence-based teaching is desired.
BACKGROUND: Residents rate morning report (MR) as an essential educational activity. Little contemporary evidence exists to guide medical educators on the optimal content or most effective delivery strategies, particularly in the era of resident duty-hour limitations and shifts towards learner-centric pedagogy in graduate medical education. OBJECTIVE: Assess resident views about MR content and teaching strategies. DESIGN: Anonymous, online survey. PARTICIPANTS: Internal medicine residents from 10 VA-affiliated residency programs. MAIN MEASURES: The 20-item survey included questions on demographics; frequency and reason for attending; opinions on who should attend, who should teach, and how to prioritize the teaching; and respondents' comfort level with participating in MR. The survey included a combination of Likert-style and multiple-choice questions with the option for multiple responses. KEY RESULTS: A total of 497 residents (46%) completed the survey, with a balanced sample of R1s (33%), R2s (35%), and R3s (31%). Self-reported MR attendance was high (31% always attend; 39% attend > 50% of the time), with clinical duties being the primary barrier to attendance (85%). Most respondents felt that medical students (89%), R1 (96%), and R2/R3s (96%) should attend MR; there was less consensus regarding including attendings (61%) or fellows (34%). Top-rated educational topics included demonstration of clinical reasoning (82%), evidence-based medicine (77%), and disease pathophysiology (53%). Respondents valued time spent on diagnostic work-up (94%), management (93%), and differential building (90%). Overall, 82% endorsed feeling comfortable speaking; fewer R1s reported comfort (76%) compared with R2s (87%) or R3s (83%, p = 0.018). Most (81%) endorsed that MR was an inclusive learning environment (81%), with no differences by level of training. CONCLUSIONS: MR remains a highly regarded, well-attended educational conference. Residents value high-quality cases that emphasize clinical reasoning, diagnosis, and management. A supportive, engaging learning environment with expert input and concise, evidence-based teaching is desired.
Entities:
Keywords:
graduate medical education; internal medicine residency; morning report; survey
Authors: Tyler J Albert; Joel Bradley; Helene Starks; Jeff Redinger; Cherinne Arundel; Albertine Beard; Laura Caputo; Jonathan Chun; Craig G Gunderson; Dan Heppe; Anand Jagannath; Kyle Kent; Michael Krug; James Laudate; Vignesh Palaniappan; Amanda Pensiero; Zaven Sargsyan; Emily Sladek; Matthew Tuck; Paul B Cornia Journal: J Gen Intern Med Date: 2021-06-25 Impact factor: 6.473