What internal medicine attendings talk about at morning report: a multicenter study

BMC Medical Education

Research

Laura M. Caputo¹  Joseph R. Sweigart²  Christine A. Mitchell³  Erik T. Ehlers³  Brian K. Kwan⁴  Michelle M. Guidry⁵  Craig G. Gunderson⁶  Kirsha S. Gordon⁶  Daniel B. Heppe⁷  Jonathan W. Chun⁸  Jessica E. Cyr⁹  Andrea C. Smeraglio^1,10  Anand D. Jagannath^1,10  Jeffrey W. Redinger^1,11  Tyler J. Albert^1,11  Paul B. Cornia^1,11  Matthew G. Tuck^1,12  Cherinne Arundel^1,13  Joel M. Bradley^1,14  James D. Laudate^1,14 

[1] Durham VA Health Care System, Durham, NC, USA;Department of Medicine, Duke University School of Medicine, Durham, NC, USA;Lexington VA Health Care System, Lexington, KY, USA;Department of Internal Medicine, University of Kentucky College of Medicine, Lexington, KY, USA;Omaha VA Medical Center, Omaha, NE, USA;Department of Internal Medicine, University of Nebraska College of Medicine, Omaha, NE, USA;San Diego VA Medical Center, San Diego, CA, USA;Department of Medicine, University of California San Diego School of Medicine, San Diego, CA, USA;Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA;Tulane University School of Medicine, New Orleans, LA, USA;VA Connecticut Health Care System, West Haven, CT, USA;Department of Medicine, Yale University School of Medicine, New Haven, CT, USA;VA Eastern Colorado Health Care System, Aurora, CO, USA;Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA;VA Palo Alto Health Care System, Palo Alto, CA, USA;Stanford University School of Medicine, Stanford, CA, USA;VA Pittsburgh Healthcare System, Pittsburgh, PA, USA;Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA;VA Portland Health Care System, Portland, OR, USA;Department of Medicine, Oregon Health & Science University, Portland, OR, USA;VA Puget Sound Health Care System, 1660 S Columbian Way, 98108, Seattle, WA, USA;Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA;Washington, DC VA Medical Center, Washington, DC, USA;Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA;Washington, DC VA Medical Center, Washington, DC, USA;Department of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA;Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA;White River Junction VA Medical Center, White River Junction, VT, USA;Department of Medicine, Geisel School of Medicine at Dartmouth, Hanover, NH, USA;

关键词: Medical education;    Graduate medical education;    Morning report;    Internal medicine residency;   

DOI  :  10.1186/s12909-023-04057-y

 received in 2022-06-14, accepted in 2023-01-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMorning report is a core educational activity in internal medicine resident education. Attending physicians regularly participate in morning report and influence the learning environment, though no previous study has described the contribution of attending physicians to this conference. This study aims to describe attending comments at internal medicine morning reports.MethodsWe conducted a prospective, observational study of morning reports conducted at 13 internal medicine residency programs between September 1, 2020, and March 30, 2021. Each attending comment was described including its duration, whether the comment was teaching or non-teaching, teaching topic, and field of practice of the commenter. We also recorded morning report-related variables including number of learners, report format, program director participation, and whether report was scripted (facilitator has advance knowledge of the case). A regression model was developed to describe variables associated with the number of attending comments per report.ResultsThere were 2,344 attending comments during 250 conferences. The median number of attendings present was 3 (IQR, 2–5). The number of comments per report ranged across different sites from 3.9 to 16.8 with a mean of 9.4 comments/report (SD, 7.4). 66% of comments were shorter than one minute in duration and 73% were categorized as teaching by observers. The most common subjects of teaching comments were differential diagnosis, management, and testing. Report duration, number of general internists, unscripted reports, and in-person format were associated with significantly increased number of attending comments.ConclusionsAttending comments in morning report were generally brief, focused on clinical teaching, and covered a wide range of topics. There were substantial differences between programs in terms of the number of comments and their duration which likely affects the local learning environment. Morning report stakeholders that are interested in increasing attending involvement in morning report should consider employing in-person and unscripted reports. Additional studies are needed to explore best practice models of attending participation in morning report.

【 授权许可】

CC BY   
© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2023