A new approach to resident morning report: introducing "VAVUM"

Internal Medicine Residents' Perceptions of Virtual Morning Report: a Multicenter Survey

IMPORTANCE

The COVID-19 pandemic disrupted graduate medical education, compelling training programs to abruptly transition to virtual educational formats despite minimal experience or proficiency. We surveyed residents from a national sample of internal medicine (IM) residency programs to describe their experiences with the transition to virtual morning report (MR), a highly valued core educational conference.

OBJECTIVE

Assess resident views about virtual MR content and teaching strategies during the COVID-19 pandemic.

DESIGN

Anonymous, web-based survey.

PARTICIPANTS

Residents from 14 academically affiliated IM residency programs.

MAIN MEASURES

The 25-item survey on virtual MR included questions on demographics; frequency and reason for attending; opinions on who should attend and teach; how the virtual format affects the learning environment; how virtual MR compares to in-person MR with regard to participation, engagement, and overall education; and whether virtual MR should continue after in-person conferences can safely resume. The survey included a combination of Likert-style, multiple option, and open-ended questions.

RESULTS

Six hundred fifteen residents (35%) completed the survey, with a balanced sample of interns (39%), second-year (31%), and third-year (30%) residents. When comparing their overall assessment of in-person and virtual MR formats, 42% of residents preferred in-person, 18% preferred virtual, and 40% felt they were equivalent. Most respondents endorsed better peer-engagement, camaraderie, and group participation with in-person MR. Chat boxes, video participation, audience response systems, and smart boards/tablets enhanced respondents' educational experience during virtual MR. Most respondents (72%) felt that the option of virtual MR should continue when it is safe to resume in-person conferences.

CONCLUSIONS

Virtual MR was a valued alternative to traditional in-person MR during the COVID-19 pandemic. Residents feel that the virtual platform offers unique educational benefits independent of and in conjunction with in-person conferences. Residents support the integration of a virtual platform into the delivery of MR in the future.

Morning report: can an established medical education tradition be validated?

BACKGROUND

Morning report is accepted as an essential component of residency education throughout different parts of the world.

OBJECTIVE

To review the evidence of the educational value, purpose, methods, and outcomes of morning report.

METHODS

A literature search of PubMed, Ovid, and the Cochrane Library for English-language studies published between January 1, 1966, and October 31, 2011, was performed. We searched for keywords and Medical Subject Heading terms related to medical education, methods, attitudes, and outcomes in regard to "morning report." Title and abstract review, followed by a full-text review by 3 authors, was performed to identify all pertinent articles.

RESULTS

We identified 71 citations; 40 articles were original studies and 31 were commentaries, editorials, or review articles; 56 studies (79%) originated from internal medicine residency programs; 6 studies (8%) focused on ambulatory morning report; and 63 (89%) originated from the United States. Identified studies varied in objectives, methods, and outcome measures, and were not suitable for meta-analysis. Main outcome measures were resident satisfaction, faculty satisfaction, preparation for professional examinations, use of evidence-based medicine, clinical effects on patient care, adverse event detection, and utilization of a curriculum in case selection.

CONCLUSIONS

Morning report has heterogeneous purposes, methods, and settings. As an educational tool, morning report is challenging to define, its outcome is difficult to measure, and this precludes firm conclusions about its contribution to resident education or patient care. Residency programs should tailor morning report to meet their own unique educational objectives and needs.

Morning report blog: a web-based tool to enhance case-based learning

BACKGROUND

Morning report is an interactive case-based teaching session common to internal medicine training programs across North America.

DESCRIPTION

We report here on a morning report web log ("blog"), created and updated after morning report sessions by the Chief Medical Resident with pertinent clinical topics, links to journal articles, and medical images. Trainees on their internal medicine rotation were e-mailed a web link with each posting. The aim was to enhance learning on clinical topics discussed at morning report by reinforcing topics and promoting further reading.

EVALUATION

The educational impact of the blog was evaluated using detailed web metrics and surveys of attendees. The intended audience spent on average more than 5 min reading the blog and viewed more than 3 pages per visit. Almost half of attendees accessed the blog after completing their internal medicine rotation. The blog was also accessed by a global audience. Trainees rated the blogs a useful learning tool and cited it to be among the top 3 educational resources accessed during their rotation.

CONCLUSIONS

In summary, a morning report blog was perceived by learners to be an effective complement to case-based teaching sessions. The combination of novel web metrics and survey data allowed for a multifaceted evaluation of the educational impact of the blog.

Morning report: is the time ripe for a change?

BACKGROUND

Morning report is a time-honored part of the medical day. However, recent changes in house officer training and staffing raise questions about the educational efficacy of this daily conference.

SUMMARY

As it is currently conducted, Morning Report is an exercise in role playing that fails to achieve its main teaching objectives. This article suggests ways to modify Morning Report in an attempt to sustain the valuable purpose for which it was initially conceived.

CONCLUSIONS

Refocusing the objectives of Morning Report and shifting the time to noon may restore the educational value of this important conference.

Clinical status: a daily forum for resident discussion and staff education

A forum at which the timely transmission of critical clinical information is coupled with a formal interdisciplinary teaching program has tremendous value in the long-term care setting. We have combined features of morning report used in teaching hospitals with attributes of "stand-up" meetings to fill this need. Each morning we hold Clinical Status, a gathering of representative staff from all neighborhoods (units) at which we discuss problems that have occurred during the previous 24 hours; admissions, discharges, and transitions; Center-wide concerns such as infection control measures; and upcoming events such as celebrations, lectures, and memorials. In addition, short educational presentations are made by staff members at each session. A survey of attendees confirms our impression that Clinical Status is regarded as an informative, stimulating and vital aspect of life at the Center.