Morning ReportMorning Report

Haleh Talaei MD, MPHHaleh Talaei MD, MPHInfectious Disease specialistInfectious Disease specialist

Clinical toxicology fellowClinical toxicology fellowAssociated professor of Shahid Beheshti University of Medical Associated professor of Shahid Beheshti University of Medical

SciencesSciences

DefinitionDefinition

The term "The term "morning reportmorning report" is used to describe " is used to describe case-based conferences where residents, case-based conferences where residents, attending physicians, and others meet to attending physicians, and others meet to present and discuss clinical cases. The term present and discuss clinical cases. The term includes resident reports, morning or housestaff includes resident reports, morning or housestaff conferences, and morning sessions but excludes conferences, and morning sessions but excludes work rounds or teaching rounds.work rounds or teaching rounds.

In a typical morning report, the team on duty In a typical morning report, the team on duty during the night presents recently admitted during the night presents recently admitted patients, followed by a general discussion of the patients, followed by a general discussion of the cases and related topics. cases and related topics.

DefinitionDefinition

It’s one of the clinical teaching method It’s one of the clinical teaching method that review the management of all of that review the management of all of admitted patients in recent 24 hrs by admitted patients in recent 24 hrs by diagnostic & treatment approach on diagnostic & treatment approach on

evidence based.evidence based.

Four major areas for reviewFour major areas for review

Purpose of morning reportPurpose of morning report OrganizationOrganization Instructional methodsInstructional methods Educational outcomesEducational outcomes

Each topic area is presented, followed by an Each topic area is presented, followed by an overall discussion at the end. overall discussion at the end.

Various purposes of morning Various purposes of morning reportreport

Education Education Evaluation of residents and quality of Evaluation of residents and quality of

services services Detection and reporting of adverse eventsDetection and reporting of adverse events Non-medical issuesNon-medical issues Social interaction. Social interaction.

Educational goalsEducational goals

Case-based teaching Case-based teaching Reviewing and planning patient managementReviewing and planning patient management Fostering presentation skillsFostering presentation skills Highlighting the unique approach of the Highlighting the unique approach of the

generalist physician generalist physician Developing intellectual curiosity and researchDeveloping intellectual curiosity and research Promoting decision-making skillsPromoting decision-making skills Self-directed learningSelf-directed learning EthicsEthics

Case-oriented teachingCase-oriented teaching was the most frequently was the most frequently

cited educational purpose of cited educational purpose of morning reports. morning reports.

Evaluation of Residents and Evaluation of Residents and Quality of ServicesQuality of Services

Evaluation of residents' attitudes (84%),Evaluation of residents' attitudes (84%), Clinical skills (63%), Clinical skills (63%), Quality of care (93%)Quality of care (93%) An effective means of case management An effective means of case management

(82%) (82%)

Although morning report was used to evaluate residents Although morning report was used to evaluate residents and quality of care, no structured instrument or rating scale and quality of care, no structured instrument or rating scale to conduct such evaluations was reported. to conduct such evaluations was reported.

Detection and Reporting of Detection and Reporting of Adverse EventAdverse Event

Morning reportMorning report can be an effective can be an effective means to detect and report adverse means to detect and report adverse events such as drug reactions. events such as drug reactions.

Non-medical issuesNon-medical issues

The programs which addressed a variety The programs which addressed a variety of non-medical issues such as social, of non-medical issues such as social, personal, ethical, political, and economic personal, ethical, political, and economic topics, as well as cost-effectiveness and topics, as well as cost-effectiveness and administrative matters (85%)administrative matters (85%)

Social InteractionSocial Interaction

Morning reportMorning report provided an opportunity for provided an opportunity for residents and faculty to socialize residents and faculty to socialize

Food and drinks during Food and drinks during morning reportmorning report and and conducted business in an informal atmosphere conducted business in an informal atmosphere that fostered social interaction. that fostered social interaction.

POINTSPOINTS

Morning Report as Morning Report as SMALL GROUP SMALL GROUP SESSIONSSESSIONS

How to How to RUNRUN morning report despite morning report despite the Attending?the Attending?

Factors Factors Influencing*Influencing* Morning report Morning report case presentation case presentation

CommonCommon morning report in morning report in UniqueUnique groupsgroups

ConclusionConclusion

In summary, residency programs used In summary, residency programs used morning reportmorning report for multiple purposes, for multiple purposes,

including education and a variety of including education and a variety of other goals. Residents favor other goals. Residents favor morning morning reportreport as an educational activity. The as an educational activity. The relative importance of each purpose of relative importance of each purpose of morning reportmorning report depends on individual depends on individual programs and, in turn, may determine programs and, in turn, may determine

the way the way morning reportmorning report will be will be organized and conducted. organized and conducted.

ReferencesReferences ZUBAIR AMIN, JESUS GUAJARDO, Morning Report Focus and Methods over the Past ZUBAIR AMIN, JESUS GUAJARDO, Morning Report Focus and Methods over the Past

Three Decades, Three Decades, Academic MedicineAcademic Medicine (2000) 75: S1-S5 (2000) 75: S1-S5

Hill RF, Tyson EP, Riley HD Jr. The culture of morning report: ethnography of a Hill RF, Tyson EP, Riley HD Jr. The culture of morning report: ethnography of a clinical teaching conference. South Med J. 1997; 90: 594 -600 clinical teaching conference. South Med J. 1997; 90: 594 -600

D'Alessandro DM. Documenting the educational content of morning D'Alessandro DM. Documenting the educational content of morning report. Arch Pediatr Adolesc Med. 1997; 151: 1151 -6report. Arch Pediatr Adolesc Med. 1997; 151: 1151 -6

Ramratnam B, Kelly G , Determinants of case selection at morning report Ramratnam B, Kelly G , Determinants of case selection at morning report J Gen Intern Med 1997 May;12(5):263-6 J Gen Intern Med 1997 May;12(5):263-6

D'Alessandro DM, Qian F. Do morning report format changes affect D'Alessandro DM, Qian F. Do morning report format changes affect educational content? Med Educ 1999 Sep;33(9):648-54educational content? Med Educ 1999 Sep;33(9):648-54

Demopoulos B, Pelzman F, Wenderoth S. Ambulatory morning report: an Demopoulos B, Pelzman F, Wenderoth S. Ambulatory morning report: an underutilized educational modality.Teach Learn Med 2001 underutilized educational modality.Teach Learn Med 2001 Winter;13(1):49-52Winter;13(1):49-52

   

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