Impact of virtual morning report on learning and well-being during the COVID-19 pandemic

Abstract

Context: The COVID-19 pandemic has severely affected medical training with social distancing requirements posing a barrier to in-person teaching and face-to-face interaction between medical students, residents, and attendings. It remains unknown whether a virtual learning format can effectively improve medical knowledge and decrease social isolation. In March 2020, the University of Hawaii Family Medicine Residency Program created a residency-wide Virtual Morning Report (VMR) as a regular gathering space to address clinical training and social needs for both learners and educators. Objective: To evaluate whether a VMR improved training and decreased isolation. Study Design: Cross-sectional anonymous online survey. Setting: Community-based family medicine residency program Population: All 21 residents, 5 clinical attendings, and 10 medical students interested in family medicine. Intervention: A VMR held online 3 times weekly with interactive, clinical case-based presentations (30 minutes) by students, residents, and attendings including community physicians. Attendance was voluntary.Main and Secondary Outcome Measures: Self-report of whether VMR improved medical knowledge and well-being.Results: Of the 37 participants (90% response), 87% reported that improving medical knowledge was a moderately or extremely important reason for attending VMR. Most reported that attending VMR improved their medical knowledge moderately or a great deal overall (78%), specifically for generating differential diagnoses (88%) and work-up (88%), and less so for history/exam (47%). With respect to social isolation, 62% reported improving well-being was an extremely or moderately important reason for attending VMR. Effect of VMR participation on social isolation was mixed with many but not all reporting that VMR improved their overall well-being moderately or a great deal (30%) by increasing morale (38%), enjoyment of medicine (54%), connecting with residents (57%), or connecting with faculty (44%).Conclusions: Virtual Morning Reports proved to be an effective clinical training tool to improve medical knowledge when COVID-19 restrictions reduced in-person teaching. While participating in Virtual Morning Reports helped to improve well-being and increase a sense of connection through regular online socialization, more intentional efforts are needed to address the social isolation of students, residents, and attendings due to the COVID-19 pandemic.

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

“…60 Some also reported heightened confidence in clinical scenarios with diagnosis and clinical reasoning, but these studies did not compare to traditional morning report. 21,23,26,44 Learners also reported feeling better organized and comfortable in conducting online oral presentations themselves after exposure to VMR discussions. 50…”

“…We included a final 40 citations in our scoping review after Level 2 screening, which included 38 journal articles and 2 conference abstracts. 20,21 Figure 1 outlines the PRISMA flow diagram of included studies after screening.…”

“…The scoping review focused on programs within North America. The majority of included studies (34 studies) were conducted in the United States of America (85.0%) 2,28,34,29,22,30,35,36,37,38,39,40,40,41,42,43,23,31,44,45,24,46, 47,33,25,26,20,21,48,49,50,51,52,53 and 6 studies 54,55,56,57,58,32 were conducted in Canada (15.0%). Two studies had international impact with learners globally using the morning report blog and The Clinical Problem Solvers podcast (Table 1).…”

“…Twenty-five studies (62.5%) were conducted among general internal medicine programs, 2,22,25,26,50,29,30,31,33,44,42,55,40, 41,54,53,39,37,36,58,35,49,52 4 studies (10.0%) included family medicine learners, 21,40,39,37,59 4 studies (10.0%) were conducted in neurology programs, 23,24,57,32 1 study in nephrology (2.5%), 42 1 study (2.5%) in rheumatology, 56 2 studies (5.0%) in cardiology, 28,45 and 2 studies (5.0%) in other programs (Table 1). 34,48…”

“…Most studies explored the impact of virtual morning report (VMR) on knowledge acquisition and retention. 21,23,25,29,30,34,35,36,38,39,40,41,42,43,44,46,47, 48,49,50,51,52,53,55,56,62,63,60,65 Two studies also evaluated if VMR improved efficiency and time spent learning 38,56 and two studies explored association between the VMR format and cognitive learning styles. 36,37 Six studies reported on clinical outcomes in the areas of inpatient diabetes management, osteoporosis, chronic back pain, opioid prescribing, and advanced care planning (Table 1).…”