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The State of Morning Report in the Current Healthcare Landscape: a National Survey of Internal Medicine Program Directors.
Lessing, Juan N; McGarry, Kelly; Schiffman, Fred; Austin, Matthew; Hepokoski, Mark; Keniston, Angela; Tammaro, Dominick; Finn, Kathleen M.
Afiliação
  • Lessing JN; Division of Hospital Medicine, Department of Medicine, Anschutz Medical Center, University of Colorado School of Medicine, Aurora, CO, USA. juan.lessing@cuanschutz.edu.
  • McGarry K; Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA.
  • Schiffman F; Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA.
  • Austin M; Department of Medicine, Yale University School of Medicine, New Haven, CT, USA.
  • Hepokoski M; Department of Medicine, University of California San Diego School of Medicine, CA and the VA San Diego Healthcare System, San Diego, CA, USA.
  • Keniston A; Division of Hospital Medicine, Department of Medicine, Anschutz Medical Center, University of Colorado School of Medicine, Aurora, CO, USA.
  • Tammaro D; Department of Medicine, Alpert Medical School at Brown University, Providence, RI, USA.
  • Finn KM; Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Gen Intern Med ; 37(7): 1665-1672, 2022 05.
Article em En | MEDLINE | ID: mdl-34585310
ABSTRACT

BACKGROUND:

Case-based Morning Report (MR) has long been the predominant educational conference in Internal Medicine (IM) residency programs. The last comprehensive survey of IM MR was in 1986. Much has changed in the healthcare landscape since 1986 that may impact MR.

OBJECTIVE:

We sought to determine the current state of MR across all US IM programs.

DESIGN:

In 2018, US IM program directors (PDs) were surveyed about the dynamics of MR at their institutions, perceived pressures, and realized changes. KEY

RESULTS:

The response rate was 70.2% (275/392). MR remains highly prevalent (97.5% of programs), although held less frequently (mean 3.9 days/week, SD 1.2), for less time (mean 49.4 min, SD 12.3), and often later in the day compared to 1986. MR attendees have changed, with more diversity of learners but less presence of educational leaders. PD presence at MR is associated with increased resident attendance (high attendance 78% vs 61%, p=0.0062) and punctuality (strongly agree/agree 59% vs 43%, p=0.0161). The most cited goal for MR is utilizing cases to practice clinical reasoning. Nearly 40% of PDs feel pressure to move or cancel MR; of those, 61.2% have done so, most commonly changing the timing (48.5%), reducing the length (18.4%), and reducing the number of sessions per week (11.7%). Compared to community-based and to community-based, university-affiliated programs, university-based programs have 2.9 times greater odds (95% CI 1.3, 6.9; p = 0.0081) and 2.5 times greater odds (95% CI 1.5, 4.4; p =0.0007), respectively, of holding MR after 9 AM, and 1.8 times greater odds (95% CI 0.8, 4.2; p = 0.1367) and 2.0 times greater odds (95% CI 1.2, 3.5; p = 0.0117), respectively, of reporting pressure to cancel or move MR compared to their counterparts.

CONCLUSIONS:

While MR ubiquity reflects its continued perceived value, PDs have modified MR to accommodate changes in the healthcare environment. This includes reduced frequency, shorter length, and moving conferences later in the day. Additional studies are needed to understand how these changes impact learning.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Visitas de Preceptoria / Internato e Residência Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Visitas de Preceptoria / Internato e Residência Idioma: En Ano de publicação: 2022 Tipo de documento: Article