Increasing Pediatric Morning Report Educational Value Through Quality Improvement

Abstract

BACKGROUND: Morning report (MR) is a common case-based conference in graduate medical education. Recent studies highlight participant dissatisfaction with the educational value of MR, but data are lacking on means for improvement. We aimed to increase MR quality and participant satisfaction at our academic pediatric residency program. METHODS: Improvement science was used to develop and implement a new standardized pediatric MR process (intervention), with 5 core educational elements and structured resident–faculty mentorship. Educational elements were measured via feedback forms and tracked using a run chart. Residents and faculty were surveyed regarding MR quality and satisfaction at baseline and 6 months postintervention; responses were analyzed using mixed effects logistic regression. RESULTS: The median of educational elements increased from 3 to 5 (5 maximum) during the 6-month study period and 12-months poststudy. Baseline and postintervention survey response rates were 90% (18 of 20) for residents and 66% (51 of 77) for faculty. Residents reporting high quality MR changed from 50% to 72% (P = .20), and faculty from 29% to 85% (P <.001). Satisfaction with MR content increased for both residents (50%–89%, P = .03) and faculty (25%–67%, P <.001). Resident satisfaction with faculty mentorship before MR increased from 28% to 78% (P = .01); satisfaction with faculty feedback after MR increased from 11% to 56% (P = .02). CONCLUSIONS: Improvement science can be used to develop a new pediatric graduate medical education process. Requiring core educational elements and providing structured mentorship were associated with improvements in pediatric MR quality and participant satisfaction.

Analysis of the university experience of undergraduate students of Education degrees

“…In this sense, a great deal of research has been carried out in relation to the assessment and satisfaction of students and graduates with the quality of their university studies, identifying the aspects that favour or hinder the achievement of their objectives at a professional and personal level [ [6] , [7] , [8] ]. Studies have focused on various areas of knowledge, such as medicine [ 9 , 10 ], university engineering studies [ 11 ] and also on the training of future teachers [ 12 ]. The results obtained in these studies show that the formative experience of students in their interaction with the university can be explained through various factors, such as academic integration, the progress of the feeling of belonging to the university institution, and vocation.…”

“…Furthermore, there have been studies on graduates who carry out their teaching activity [ 18 ], but focused on determining the assessment of their activity according to the type of work centre, rather than in relation to the quality of their university and training experience. Therefore, it is worth noting that the general satisfaction of students and graduates with different studies at higher education institutions has been analysed [ [9] , [10] , [11] ]; however, there is less research focused on students and graduates of early childhood and primary education teacher training degrees [ 19 ].…”

Reframing morning report: Cognitive simulation in a safe space

“…Residents present pertinent history, exam findings, workup, differential diagnosis and medical management to their peers as well as their attending physicians that include programme directors, instructors and mentors. Its educational value is currently in question as the lack of guidance in MR preparation, the variation in content quality and lack of MR standardisation are recognised pitfalls 2–4 . Moreover, the lack of a deliberate process to create psychological safety during MR may cause fear of failure among residents and shift the focus from learning to evaluation at the expense of growth and skill acquisition 5,6 …”

“…Its educational value is currently in question as the lack of guidance in MR preparation, the variation in content quality and lack of MR standardisation are recognised pitfalls. [2][3][4] Moreover, the lack of a deliberate process to create psychological safety during MR may cause fear of failure among residents and shift the focus from learning to evaluation at the expense of growth and skill acquisition. 5,6 Emerging evidence demonstrates the potential for improvement in paediatric MR education through inclusion of five core educational elements: curriculum objectives, American Board of Pediatrics (ABP) content alignment, evidence-based literature, board review questions and take-home points.…”

“…5,6 Emerging evidence demonstrates the potential for improvement in paediatric MR education through inclusion of five core educational elements: curriculum objectives, American Board of Pediatrics (ABP) content alignment, evidence-based literature, board review questions and take-home points. 3 Of note, psychological safety was not included in these five elements. There is literature on attitudinal data from residents regarding the lack of psychological safety in the MR…”