Original Article

A Multicenter Observational Study Comparing Virtual with In-Person Morning Reports during the COVID-19 Pandemic

Authors: Joel M. Bradley, MD, Jeffrey W. Redinger, MD, Matthew G. Tuck, MD, Joseph R. Sweigart, MD, Andrea C. Smeraglio, MD, Christine A. Mitchell, MD, James D. Laudate, MD, Brian K. Kwan, MD, Anand D. Jagannath, MD, Daniel B. Heppe, MD, Michelle M. Guidry, MD, Erik T. Ehlers, MD, Jessica E. Cyr, MD, Paul B. Cornia, MD, Jonathan W. Chun, MD, Laura M. Caputo, MD, Cherinne Arundel, MD, Tyler J. Albert, MD, Craig G. Gunderson, MD

Abstract

Objectives: The coronavirus disease 2019 (COVID-19) pandemic disrupted how educational conferences were delivered, leaving programs to choose between in-person and virtual morning report formats. The objective of our study was to describe morning reports during the COVID-19 pandemic, including the use of virtual formats, attendance, leadership, and content.

Methods: A prospective observational study of morning reports was conducted at 13 Internal Medicine residency programs between September 1, 2020 and March 30, 2021, including a follow-up survey of current morning report format in January 2023.

Results: In total, 257 reports were observed; 74% used virtual formats, including single hospital, multiple hospital, and a hybrid format with both in-person and virtual participants. Compared with in-person reports, virtual reports had more participants, with increased numbers of learners (median 21 vs 7; P < 0.001) and attendings (median 4 vs 2; P < 0.001), and they were more likely to involve medical students (83% vs 40%; P < 0.001), interns (99% vs 53%; P < 0.001), and program directors (68% vs 32%; P < 0.001). Attendings were less likely to lead virtual reports (3% vs 28%, P < 0.001). Virtual reports also were more likely to be case based (88% vs 69%; P < 0.001) and to use digital presentation slides (91% vs 36%; P < 0.001). There was a marked increase in the number of slides (median 20 vs 0; P < 0.001). As of January 2023, all 13 programs had returned to in-person reports, with only 1 program offering an option to participate virtually.

Conclusions: During the COVID-19 pandemic, virtual morning report formats predominated. Compared with traditional in-person reports, virtual report increased attendance, favored resident leadership, and approached a similar range of patient diagnoses with a greater number of case-based presentations and slides. In spite of these characteristics, all programs returned to an in-person format for morning report as pandemic restrictions waned.

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References

1. Parrino TA, Villanueva AG. The principles and practice of morning report. JAMA 1986;256:730-733.
 
2. McNeill M, Ali SK, Banks DE, et al. Morning report: can an established medical education tradition be validated? J Grad Med Educ 2013;5:374-384.
 
3. Amin Z, Guajardo J, Wisniewski W, et al. Morning report: focus and methods over the past three decades. Acad Med 2000;75:S1-S5.
 
4. Heppe DB, Beard AS, Cornia PB, et al. A multicenter study of the format and content of internal medicine morning report. J Gen Intern Med 2020; 35:3591-3596.
 
5. Albert TJ, Redinger J, Starks H, et al. Internal medicine residents’ perceptions of morning report: a multicenter study. J Gen Intern Med 2021;36:647-653.
 
6. Dousa KM, Muneer M, Rahil A, et al. Tailoring morning reports to an internal medicine residency in Qatar. J Grad Med Educ 2014;6:801-804.
 
7. Albert TJ, Bradley J, Starks H, et al. Internal medicine residents’ perceptions of virtual morning report: a multicenter survey. J Gen Intern Med 2022;37: 1422-1428.
 
8. Redinger JW, Cornia PB, Albert TJ. Teaching during a pandemic. J Grad Med Educ 2020;14:403-405.
 
9. Albert TJ, Hagan SL, Newman TA, et al. Seattle VICE: virtual interactive case-based education. Med Educ 2020;54:1069-1070.
 
10. Almarzooq Z, Lopes M, Kochar A. Virtual learning during the COVID-19 pandemic: a disruptive technology in graduate medical education. J Am Coll Cardiol 2020;75:2635-2638.
 
11. Tisdale R, Filsoof AR, Singhal S. Novel graduate medical education in the era of a novel virus. J Grad Med Educ 2020;12:409-411.
 
12. Gordon M, Patricio M, Horne L, et al. Developments in medical education in response to the COVID-19 pandemic: a rapid BEME systematic review: BEME Guide No. 63. Med Teach 2020;42:1202-1215.
 
13. Tsyrulnik A, Gottlieb M, Coughlin RF, et al. Socially distanced, virtually connected: faculty and resident perceptions of virtual didactics. AEM Educ Train 2021;5:e10617.
 
14. Murdock HM, Penner JC, Le S, et al. Virtual morning report during COVID-19: a novel model for case-based teaching conferences. Med Educ 2020;54:851-852.
 
15. Sawatsky AP, Zickmund SL, Berlacher K, et al. Understanding resident learning preferences within an internal medicine noon conference lecture series: a qualitative study. J Grad Med Educ 2014;6:32-38.
 
16. Sawatsky AP, Zickmund SL, Berlacher K, et al. Understanding the challenges to facilitating active learning in the resident conferences: a qualitative study of internal medicine faculty and resident perspectives. Med Educ Online 2015;20:27289.
 
17. Zureick AH, Burk-Rafel J, Purkiss JA, et al. The interrupted learner: how distractions during live and video lectures influence learning outcomes. Anat Sci Educ 2018;11:366-376.
 
18. Mendel A, Lott A, Lo L, et al. A matter of urgency: reducing clinical text message interruptions during educational sessions. J Hosp Med 2018;13:616-622.
 
19. Wieland ML, Loertscher LL, Nelson DR, et al. A strategy to reduce interruptions at hospital morning report. J Grad Med Educ 2010;2:83-84.
 
20. Maitra A, Langone C, Baker O, et al. Assessment of interruptive behavior at residency teaching conferences by gender. JAMA Netw Open 2021; 4:e2033469.
 
21. Hamstra SJ, Yamazaki K, Barton MA, et al. A national study of longitudinal consistency in ACGME milestone ratings by clinical competency committees: exploring an aspect of validity in the assessment of residents’ competence. Acad Med 2019;94:1522-1531.
 
22. Lessing JN, McGarry K, Schiffman F, et al. The state of morning report in the current healthcare landscape: a national survey of internal medicine program directors. J Gen Intern Med 2022;37:1665-1672.
 
23. Redinger JW, Heppe DB, Albert TJ, et al. What internal medicine attendings talk about at morning report: a multicenter study. BMC Med Educ 2023;23:84.
 
24. Englander R, Holmboe E, Batalden P, et al. Coproducing health professions education: a prerequisite to coproducing health care services? Acad Med 2020;95:1006-1013.
 
25. Myers JS, Wong BM. Measuring outcomes in quality improvement education: success is in the eye of the beholder. BMJ Qual Saf 2019;28:345-348.
 
26. Zafar MA, Diers T, Schauer DP, et al. Connecting resident education to patient outcomes: the evolution of a quality improvement curriculum in an internal medicine residency. Acad Med 2014;89:1341-1347.