Morning report goes virtual: learner experiences in a virtual, case-based diagnostic reasoning conference

Abstract Objectives Participation in case-based diagnostic reasoning (DR) conferences has previously been limited to those who can attend in-person. Technological advances have enabled these conferences to migrate to virtual platforms, creating an opportunity to improve access and promote learner participation. We describe the design and evaluation of virtual morning report (VMR), a novel case-based DR conference that aimed to expand access to these conferences, leverage a virtual platform to create new opportunities for learner participation, and improve learner confidence in performing DR. Methods VMR took place on a videoconferencing platform. Participants included health professions students, post-graduate trainees, and practitioners. In designing VMR, we adapted concepts from the experience-based model of learning to design opportunities for learner participation. Teaching strategies were informed by information-processing and situativity theories. We evaluated learner experiences in VMR using a survey with open and closed-ended questions. Survey items focused on accessing case-based teaching conferences outside of VMR, participant perceptions of the educational value of VMR, and VMR’s impact on participants’ confidence in performing DR. We used thematic analysis to manually code open-ended responses and identify themes. Results 203 participants (30.2%) completed the survey. 141 respondents (69.5%) reported they did not otherwise have access to a DR conference. The majority of participants reported increased confidence performing DR. Respondents highlighted that VMR supplemented their education, created a supportive learning environment, and offered a sense of community. Conclusions VMR can expand access to DR education, create new opportunities for learner participation, and improve learner confidence in performing DR.

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Morning Report Goes Virtual: Learner Experiences in a Virtual, Case-Based Diagnostic Reasoning Conference

10.21203/rs.3.rs-535863/v1 ◽

2021 ◽

Author(s):

John C. Penner ◽

Stephenie Le ◽

Lindsey C. Shipley ◽

H. Moses Murdock ◽

Daniel J. Minter ◽

...

Keyword(s):

Qualitative Content Analysis ◽

Diagnostic Reasoning ◽

Morning Report ◽

Educational Value ◽

Learner Participation ◽

Technological Advances ◽

Experience Based Learning ◽

Graduate Trainees ◽

Supportive Learning Environment ◽

Case Based

Abstract Background: Participation in case-based diagnostic reasoning (DR) conferences has previously been limited to those who can attend in-person. Technological advances have enabled these conferences to migrate to virtual platforms, creating an opportunity to improve access and learner participation. We describe the design and evaluation of virtual morning report (VMR), a novel case-based DR conference.Methods: VMR took place on a videoconferencing platform. Participants included health professions students, post-graduate trainees, and practitioners. In designing VMR, we adapted concepts from experience-based learning theory to design opportunities for learner participation. Teaching strategies were informed by information-processing and situativity theories. We evaluated learner experiences in VMR using a survey with open and closed-ended questions. Survey items focused on accessing case-based teaching conferences outside of VMR, participant perceptions of the educational value of VMR, and VMR’s impact on participants’ confidence in performing DR. We used qualitative content analysis to manually code open-ended responses and identify themes. Results: 203 participants (30.2%) completed the survey. 141 respondents (69.5%) did not otherwise have access to a DR conference. The majority of participants reported increased confidence performing DR. Respondents highlighted that VMR supplemented their education, created a supportive learning environment, and offered a sense of community.Conclusions: VMR can expand access to DR education, create new opportunities for learner participation, and improve learner confidence in performing DR.

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Assessing Diagnostic Reasoning Using a Standardized Case-Based Discussion

Journal of Medical Education and Curricular Development ◽

10.1177/2382120519849411 ◽

2019 ◽

Vol 6 ◽

pp. 238212051984941 ◽

Cited By ~ 2

Author(s):

Ruth M Sutherland ◽

Katharine J Reid ◽

Neville G Chiavaroli ◽

David Smallwood ◽

Geoffrey J McColl

Keyword(s):

Medical Students ◽

Student Performance ◽

Clinical Training ◽

Medical Training ◽

Clinical Information ◽

Performance Standards ◽

Diagnostic Reasoning ◽

First Year ◽

Oral Assessment ◽

Case Based

Background: Development of diagnostic reasoning (DR) is fundamental to medical students’ training, but assessing DR is challenging. Several written assessments focus on DR but lack the ability to dynamically assess DR. Oral assessment formats have strengths but have largely lost favour due to concerns about low reliability and lack of standardization. Medical schools and specialist medical colleges value many forms of oral assessment (eg, long case, Objective Structured Clinical Examination [OSCE], viva voce) but are increasingly searching for ways in which to standardize these formats. We sought to develop and trial a Standardized Case-Based Discussion (SCBD), a highly standardized and interactive oral assessment of DR. Methods: Two initial cohorts of medical students (n = 319 and n = 342) participated in the SCBD as part of their assessments. All students watch a video trigger (based on an authentic clinical case) and discuss their DR with an examiner for 15 minutes. Examiners probe students’ DR and assess how students respond to new standardized clinical information. An online examiner training module clearly articulates expected student performance standards. We used student achievement and student and examiner perceptions to gauge the performance of this new assessment form over 2 implementation years. Results: The SCBD was feasible to implement for a large student cohort and was acceptable to students and examiners. Most students and all examiners agreed that the SCBD discussion provided useful information on students’ DR. The assessment had acceptable internal consistency, and the associations with other assessment formats were small and positive, suggesting that the SCBD measures a related, yet novel construct. Conclusions: Rigorous, standardized oral assessments have a place in a programme of assessment in initial medical training because they provide opportunities to explore DR that are limited in other formats. We plan to incorporate an SCBD into our clinical assessments for the first year of clinical training, where teaching and assessing basic DR is emphasized. We will also explore further examiners’ understanding of and approach to assessing DR.

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The Educational Value of a Primary Care Clerkship Morning Report

Teaching and Learning in Medicine ◽

10.1207/s15328015tlm1003_7 ◽

1998 ◽

Vol 10 (3) ◽

pp. 162-166

Author(s):

Jacqueline L. Brown ◽

Raymond H. Curry ◽

Adnan Arseven ◽

Paul R. Yarnold ◽

Gary J. Martin

Keyword(s):

Primary Care ◽

Morning Report ◽

Educational Value

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Design and implementation of pharmacy morning report: An adaptation of medical morning report for case-based instruction in the pharmacy curriculum

Currents in Pharmacy Teaching and Learning ◽

10.1016/j.cptl.2016.05.003 ◽

2016 ◽

Vol 8 (5) ◽

pp. 609-614 ◽

Cited By ~ 1

Author(s):

Bruce A. Waldrop ◽

Angela R. Thomason

Keyword(s):

Morning Report ◽

Design And Implementation ◽

Based Instruction ◽

Pharmacy Curriculum ◽

Case Based

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A Case-Based Approach to Understanding Complex Genetic Information in an Evolving Landscape

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_321041 ◽

2021 ◽

pp. 1-11

Author(s):

Courtney D. DiNardo ◽

Larissa A. Korde ◽

Matthew B. Yurgelun

Keyword(s):

Genetic Testing ◽

Genetic Information ◽

Cancer Susceptibility ◽

Susceptibility Gene ◽

Somatic Mosaicism ◽

Inherited Cancer ◽

Clonal Hematopoiesis ◽

Pathogenic Variants ◽

Technological Advances ◽

Case Based

The rapid integration of highly sensitive next-generation sequencing technologies into clinical oncology care has led to unparalleled progress, and yet these technological advances have also made genetic information considerably more complex. For instance, accurate interpretation of genetic testing for germline/inherited cancer predisposition syndromes and somatic/acquired pathogenic variants now requires a more nuanced understanding of the presence and incidence of clonal hematopoiesis and circulating tumor cells, with careful evaluation of pathogenic variants occurring at low variant allele frequency required. The interplay between somatic and germline pathogenic variants and awareness of distinct genotype-phenotype manifestations in various inherited cancer syndromes are now increasingly appreciated and can impact patient management. Through a case-based approach, we focus on three areas of particular relevance to the treating clinician oncologist: (1) understanding clonal hematopoiesis and somatic mosaicism, which can be detected on germline sequencing and lead to considerable confusion in clinical interpretation; (2) implications of the detection of a potentially germline pathogenic variant in a high-penetrance cancer susceptibility gene during routine tumor testing; and (3) a review of gene-specific risks and surveillance recommendations in Lynch syndrome. A discussion on the availability and difficulties often associated with direct-to-consumer genetic testing is also provided.

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Strukturiertes fallorientiertes Lernen

psychopraxis neuropraxis ◽

10.1007/s00739-020-00655-3 ◽

2020 ◽

Vol 23 (5) ◽

pp. 240-245

Author(s):

Sebastian Ertl ◽

Laurenz Stastka ◽

Henriette Löffler-Stastka

Keyword(s):

Diagnostic Reasoning ◽

Interdisziplinäres Vorgehen ◽

E Learning ◽

Case Based

Zusammenfassung Ein modernes „case-based“ E‑Learning ist ein exzellentes Hilfsmittel, um Skills und Kommunikation zu trainieren, da „diagnostic reasoning“ als schematisches Problemlösen gesehen wird. Wir präsentieren einen Patientenfall zum Thema Gerinnungsstörung bei chronischem Substanzmissbrauch, bei dem nur durch interdisziplinäres Vorgehen ein adäquater Erfolg erzielt werden kann. Diesbezüglich ist zu erwähnen, dass zu diesem Thema noch wenig Evidenz vorhanden ist und es noch weiterer Forschung bedarf.

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Use of Ecological Momentary Assessment to Guide Curricular Change in Graduate Medical Education

Journal of Graduate Medical Education ◽

10.4300/jgme-d-10-00165.1 ◽

2011 ◽

Vol 3 (2) ◽

pp. 162-167 ◽

Cited By ~ 2

Author(s):

Lisa L. Willett ◽

Carlos A. Estrada ◽

Terry C. Wall ◽

Heather L. Coley ◽

Julius Ngu ◽

...

Keyword(s):

Ecological Momentary Assessment ◽

Assessment Tool ◽

Curricular Change ◽

Morning Report ◽

Evaluation Tool ◽

Cognitive Content ◽

Educational Value ◽

Before And After ◽

Ecological Momentary ◽

Momentary Assessment

Abstract Purpose To assess whether a novel evaluation tool could guide curricular change in an internal medicine residency program. Method The authors developed an 8-item Ecological Momentary Assessment tool and collected daily evaluations from residents of the relative educational value of 3 differing ambulatory morning report formats (scale: 8 = best, 0 = worst). From the evaluations, they made a targeted curricular change and used the tool to assess its impact. Results Residents completed 1388 evaluation cards for 223 sessions over 32 months, with a response rate of 75.3%. At baseline, there was a decline in perceived educational value with advancing postgraduate (PGY) year for the overall mean score (PGY-1, 7.4; PGY-2, 7.2; PGY-3, 7.0; P < .01) and for percentage reporting greater than 2 new things learned (PGY-1, 77%; PGY-2, 66%; PGY-3, 50%; P < .001). The authors replaced the format of a lower scoring session with one of higher cognitive content to target upper-level residents. The new session's mean score improved (7.1 to 7.4; P = .03); the adjusted odds ratios before and after the change for percentage answering, “Yes, definitely” to “Area I need to improve” was 2.53 (95% confidence interval [CI], 1.45–4.42; P = .001) and to “Would recommend to others,” it was 2.08 (95% CI, 1.12–3.89; P = .05). Conclusions The Ecological Momentary Assessment tool successfully guided ambulatory morning report curricular changes and confirmed successful curricular impact. Ecological Momentary Assessment concepts of multiple, frequent, timely evaluations can be successfully applied in residency curriculum redesign.

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