A scoping review of virtual morning report and outcomes in Canada and the United States

Abstract

Purpose: To describe the current landscape of virtual morning report (VMR) in medical residency education including its varying formats, methods, and associated effectiveness on learning and clinical outcomes. Methods: The authors conducted a scoping review using the Arksey and OMalley methodology. They searched Embase, OvidMEDLINE, Google Scholar, and PubMed between January 1, 1991 to April 15, 2022. Articles written in English on virtual morning report and virtual case-based teaching in medical residency programs were captured. Two authors independently screened articles using the inclusion criteria. Using a snowball approach, further citations were identified from included references. Two authors performed data extraction including outcomes using the Kirkpatrick model. We conducted thematic analysis using an iterative process. Results: A total of 401 citations were screened for eligibility and we included 40 articles. The number of published studies per year on VMR increased since the COVID-19 pandemic. Most studies used online case-based modules (n=20, 50.0%) or videoconferencing (n=12, 30.0%). The majority of studies described improved confidence with clinical reasoning, easy access, and preference for chatboxes and polls for engagement (Kirpatrick level 1). Nineteen studies demonstrated improved knowledge acquisition with pre-and post-test scores (Kirkpatrick level 2). Behaviour changes (Kirkpatrick level 3) included improved screening tests and medication prescribing. There were no studies on clinical outcomes (Kirkpatrick level 4). Thematic analyses revealed that VMR increased clinical reasoning, efficiently used technology, provided an inclusive environment for diverse learners, but reduced peer engagement and bedside teaching. Conclusion: Virtual morning report has a positive impact on learner confidence, knowledge, inclusivity, accessibility, and behaviour change. Future research is needed to explore the impact on patient outcomes as well as identify strategies for peer engagement and social interaction.