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Resident Expectations of Morning Report
A Multi-institutional Study
Cary P. Gross, MD;
Gerard B. Donnelly, MD;
Anna B. Reisman, MD;
Kent A. Sepkowitz, MD;
Mark A. Callahan, MD
Arch Intern Med. 1999;159:1910-1914.
Background Morning report, a cornerstone of internal medicine residency programs for many years, involves a diverse group of teachers and learners with heterogeneous learning goals.
Methods We distributed a self-administered, cross-sectional survey to internal medicine residents to clarify the objectives of the learners at morning report. We selected a convenience sample of internal medicine residents at community- and university-based programs. Questions were answered in a Likert scale or multiple-choice format.
Results Residents from 13 residency programs in 7 states participated. We received 356 completed surveys, which represented a 63% response rate. The house staff in our sample preferred that half of the guest attending physicians be generalists. They indicated that the primary function of morning report should be educational, and preferred to discuss the management of a few interesting cases rather than review all patients admitted the previous day. The majority of respondents (60.8%) favored a stepwise presentation of cases to simulate the chronology of receiving information. Disease process, diagnostic workup, and evaluation of tests and procedures were all considered important topics for discussion, while medical ethics and research methods were viewed as less important. Responses varied little when stratified by sex, postgraduate year, type of residency program, subspecialty fellowship plans, or location of medical school.
Conclusions Residents from a diverse group of programs expressed remarkably similar opinions about morning report. Consistent with the recently increased emphasis on ambulatory care and general internal medicine in residency training, they expressed a desire for about 50% of the guest attending physicians to be generalists. In addition, they preferred a style in which challenging cases were presented in a stepwise manner.
From the Departments of Internal Medicine, The Johns Hopkins University School of Medicine (Drs Gross and Reisman) and Memorial Sloan-Kettering Cancer Center (Drs Donnelly and Sepkowitz), Baltimore, Md; and the Division of General Internal Medicine, Cornell University Medical College, New York, NY (Dr Callahan). Dr Gross is now with the Division of Primary Care, Yale University School of Medicine, New Haven, Conn.
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Evidence-Based Medicine: Resident Preferences for Morning Report
Larissa Nekhlyudov, Prem G. Thomas, Susana D'Amico, Sherri A. Clayton, Cary P. Gross, Anna B. Reisman, Gerald B. Donnelly, Kent A. Sepkowitz, and Mark A. Callahan
Arch Intern Med. 2000;160(4):552-553.
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