The culture of morning report: ethnography of a clinical teaching conference.

We studied the structure, process, and subjective meaning of "morning report," a time-honored, medical teaching conference attended by faculty, house officers, and students at a pediatric teaching hospital. Methods included participant observation, focused interviews, and content analyses. Results showed substantial variation by rank in behavior, perception, and participation based on a highly structured division of labor. The most frequent suggestion for improving morning report was to shorten it. Data indicate that morning report, at least at our study site, is out of step with current learner-centered models, seems perfunctory, and may be costly in the current climate of decreased revenues and downsizing. The persistence of morning report, despite these liabilities, attests to its significance as a cultural event.