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Al Qarni A, Habib A, Abdelgadir E, Al Sarawi A, Alqannas N, Alkroud A. The Morning Report Practice and Its Contribution to Education of Internal Medicine Residents: A Multicenter Cross-Sectional Survey in the Eastern Province, Saudi Arabia. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:713-722. [PMID: 37455858 PMCID: PMC10348320 DOI: 10.2147/amep.s414986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
Background Morning Report (MR) is a ubiquitous traditional educational activity in internal medicine residency training. It is under-researched; hence, this study was conducted. It aimed to examine the practice of MR by internal medicine residents, their motivation to engage with it, and their perception of its contribution to education. Methods This was a multi-center cross-sectional study. The data was collected using an online self-administered 12-item questionnaire that covered MR practice, respondents' motivation for participation, MR contribution to education, and its impact on the practice of evidence-based medicine and quality improvement and patient safety. Results One hundred seventy residents returned the online questionnaire (54.7%). The respondents' gender and year of training were balanced (P > 0.05). The most common MR frequency and duration were five days per week (85.4%) and 45-60 minutes (47.1%), respectively. The most common format was handover combined with an emergency long case presentation (55.8%), and consultants were the most common facilitators (79.7%). The respondents' motivation to engage with MR was predominantly intermediate. The top reasons for attending and not attending MR were mandatory attendance and embarrassing questions, respectively. The perceived MR contribution to residents' different roles development was predominantly intermediate; however, it was predominantly very low/low (42%) for overall education. The perceived MR impact on the practice of EBM and QIPS were both predominantly intermediate. Conclusion MR was found to be a commonly practiced educational activity in internal medicine residency training programs in the eastern province of Saudi Arabia. The case discussion was the core format for education. The respondents' motivation to participate in MR and their perception of its contribution to education was predominantly intermediate. To our best knowledge, this is the first study in Saudi Arabia that examined MR. We hope its findings will be taken for further MR studies and actions for improvement.
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Affiliation(s)
- Ali Al Qarni
- Department of Medicine, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al Ahsa, Saudi Arabia
- King Abdullah International Medical Research Center, Al Ahsa, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
| | - Ahmad Habib
- Department of Medicine, King Fahd Military Medical Complex (KFMMC), Dhahran, Saudi Arabia
| | - Elbadri Abdelgadir
- Department of Medicine, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al Ahsa, Saudi Arabia
| | - Abdulaziz Al Sarawi
- Department of Medicine, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al Ahsa, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences, Al Ahsa, Saudi Arabia
| | - Naif Alqannas
- Saud Al Babtain Cardiac Centre, Eastern Health Cluster, Dammam, Saudi Arabia
| | - Ammar Alkroud
- Department of Medicine, Johns Hopkins Aramco Healthcare (JHAH), Al Ahsa, Saudi Arabia
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Chen LYC, Quach TTT, Dayan R, Giustini D, Teunissen PW. Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review. CMAJ Open 2023; 11:E411-E425. [PMID: 37160324 PMCID: PMC10174266 DOI: 10.9778/cmajo.20210203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Classroom-based education (CBE) is ubiquitous in postgraduate medical education (PGME), but to date no studies have synthesized the literature on the topic. We conducted a scoping review focusing on academic half days and noon conferences. METHODS We searched 4 databases (MEDLINE [OVID], Embase [OVID], ERIC [EBSCO] and Web of Science) from inception to December 2021, performed reference and citation harvesting, and applied predetermined inclusion and exclusion criteria to our screening. We used 2 frameworks for the analysis: "experiences, trajectories and reifications" and "description, justification and clarification." RESULTS We included 90 studies, of which 55 focused on resident experiences, 29 on trajectories and 6 on reification. We classified 44 studies as "description," 38 as "justification" and 8 as "clarification." In the description studies, 12 compared academic half days with noon conferences, 23 described specific teaching topics, and 9 focused on resources needed for CBE. Justification studies examined the effects of CBE on outcomes, such as examination scores (17) and use of teaching strategies in team-based learning, principles of adult learning and e-learning (15). Of the 8 clarification studies, topics included the role of CBE in PGME, stakeholder perspectives and transfer of knowledge between classroom and workplace. INTERPRETATION Much of the existing literature is either a description of various aspects of CBE or justification of particular teaching strategies. Few studies exist on how and why CBE works; future studies should aim to clarify how CBE facilitates resident learning within the sociocultural framework of PGME.
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Affiliation(s)
- Luke Y C Chen
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Tien T T Quach
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Riki Dayan
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Dean Giustini
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Pim W Teunissen
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
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Bowman Peterson JM, Duffy B, Duran A, Gladding SP. Interactive value-based curriculum: a pilot study. CLINICAL TEACHER 2018; 16:64-70. [PMID: 29508530 DOI: 10.1111/tct.12771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Current health care costs are unsustainable, with a large percentage of waste attributed to doctor practices. Medical educators are developing curricula to address value-based care (VBC) in education. There is, however, a paucity of curricula and assessments addressing levels higher than 'knows' at the base of Miller's pyramid of assessment. Our objective was to: (1) teach residents the principles of VBC using active learning strategies; and (2) develop and pilot a tool to assess residents' ability to apply principles of VBC at the higher level of 'knows how' on Miller's pyramid. METHODS Residents in medicine, medicine-paediatrics and medicine-dermatology participated in a 5-week VBC morning report curriculum using active learning techniques. Early sessions targeted knowledge and later sessions emphasised the application of VBC principles. Medical educators are developing curricula to address value-based care in education RESULTS: Thirty residents attended at least one session and completed both pre- and post-intervention tests, using a newly developed case-based assessment tool featuring a 'waste score' balanced with 'standard of care'. Residents, on average, reduced their waste score from pre-intervention to post-intervention [mean 8.8 (SD 6.3) versus mean 4.7 (SD 4.6), p = 0.001]. For those who reduced their waste score, most maintained or improved their standard of care. DISCUSSION Our results suggest that residents may be able to decrease health care waste, with the majority maintaining or improving their management of care in a case-based assessment after participation in the curriculum. We are working to further incorporate VBC principles into more morning reports, and to develop further interventions and assessments to evaluate our residents at higher levels on Miller's pyramid of assessment.
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Affiliation(s)
| | - Briar Duffy
- Department of Medicine, University of Minnesota Medical School, Minneapolis, USA
| | - Alisa Duran
- Department of Medicine, University of Minnesota Medical School, Minneapolis, USA
| | - Sophia P Gladding
- Department of Medicine, University of Minnesota Medical School, Minneapolis, USA
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Adams T. Use of the morning report to teach high-value care. CLINICAL TEACHER 2017; 13:315. [PMID: 27424544 DOI: 10.1111/tct.12507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Traci Adams
- University of Texas Southwestern Medical Center, Department of Pulmonary and Critical Care Medicine, Dallas, Texas, USA
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Tran DM, Forbes MP. Addressing cost of unwarranted medical care in the medical curriculum. AUST HEALTH REV 2017; 41:151-153. [DOI: 10.1071/ah15172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 06/07/2016] [Indexed: 11/23/2022]
Abstract
Within the past decade, there has been a significant increase in Australia’s health expenditure, with a concurrent rise in overdiagnosis. Australia has introduced the Choosing Wisely campaign in a bid to identify and reduce commonly used investigations, treatments and procedures that add little benefit to patient care. By catalysing a discussion regarding evidence-based use of medications and medical testing, the Choosing Wisely campaign can minimise risk of harm to patients, as well as reduce expenditure. Internationally, several institutions are considering introducing training regarding cost-effective medical investigations into medical school curricula. The American College of Radiology has found positive results when conducting small-group teaching sessions with medical students regarding appropriate imaging modalities. These results are reflected in a US study that used an educational intervention to improve students’ understanding of investigation costs. In addition, the Academy of Clinical Laboratory Physicians and Scientists has developed a proposed curriculum to further medical students’ training in appropriate ordering of laboratory investigations. Australian medical educators must consider whether introducing evidence-based testing into Australian medical curricula should be part of a wider strategy to prevent unnecessary testing and health expenditure now and into the future.
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Kumar R, Farnan JM, Shah NT, Levy A, Saathoff M, Arora VM. GOTMeDS?: Development and Evaluation of an Interactive Module for Trainees on Reducing Patient's Drug Costs. Am J Med 2016; 129:1338-1342. [PMID: 27591181 DOI: 10.1016/j.amjmed.2016.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 01/12/2016] [Accepted: 08/17/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Rupali Kumar
- Physical Medicine & Rehabilitation, Stanford University, Stanford, Calif
| | | | - Neel T Shah
- Department of Medicine, University of Chicago, Ill; Department of Obstetrics and Gynecology, Harvard University, Cambridge, Mass
| | - Andrew Levy
- Costs of Care, Inc., Boston, Mass; Division of Cardiology, Department of Medicine, University of Colorado, Denver
| | | | - Vineet M Arora
- Department of Medicine, University of Chicago, Ill; Costs of Care, Inc., Boston, Mass.
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