Resident expectations of morning report - A multi-institutional study

Background: Morning report, a cornerstone of internal medicine residency pr ograms for many years, involves a diverse group of teachers and learners wi th heterogeneous learning goals. Methods: We distributed a self-administered, cross-sectional survey to inte rnal medicine residents to clarify the objectives of the learners at mornin g report. We selected a convenience sample of internal medicine residents a t community- and university-based programs. Questions were answered in a Li kert 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 physic ians be generalists. They indicated that the primary function of morning re port should be educational, and preferred to discuss the management of a fe w interesting cases rather than review all patients admitted the previous d ay. 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 conside red important topics for discussion, while medical ethics and research meth ods were viewed as less important. Responses varied little when stratified by sex, postgraduate year, type of residency program, subspecialty fellowsh ip plans, or location of medical school. Conclusions: Residents from a diverse group of programs expressed remarkabl y similar opinions about morning report. Consistent with the recently incre ased emphasis on ambulatory care and general internal medicine in residency training, they expressed a desire for about 50% of the guest attending phy sicians to be generalists. In addition, they preferred a style in which cha llenging cases were presented in a stepwise manner.