Morning report for all: a qualitative study of disseminating case conferences via podcasting

Abstract

Background Despite its long-established importance, diagnostic reasoning (DR) education has suffered uneven implementation in medical education. The Clinical Problem Solvers (CPSolvers) podcast has emerged as a novel strategy to help teach DR through case conferences with expert diagnosticians and trainees. CPSolvers has 25,000 listeners in 147 countries. The aim of this study was to evaluate the podcast by eliciting the developers’ goals of the podcast, then determining to what extent they aligned with the listeners’ actual usage habits, features they valued, and perceptions of the podcast. Methods We conducted semi-structured interviews with 3 developers and 8 listeners from April–May 2020, followed by qualitative thematic analysis. Results Three major developer goals with sub-goals resulted: To teach diagnostic reasoning in a case-based format by (1a) teaching schemas, (1b) modeling expert diagnostic reasoning, (1c) teaching clinical knowledge, and (1d) teaching diagnostic reasoning terminology. To change the culture of medicine by (2a) promoting diversity, (2b) modeling humility and promoting psychological safety, and (2c) creating a fun, casual way to learn. To democratize the teaching of diagnostic reasoning by leveraging technology. Listeners’ usage habits, valued features, and perceptions overall strongly aligned with all these aspects, except for (1c) clinical knowledge, and (1d) diagnostic reasoning terminology. Listeners identified (1a) schemas, and (2c) promotion of psychological safety as the most valuable features of the podcast. Conclusion CPSolvers has been perceived as a highly effective and novel way to disseminate DR education in the form of case conferences, serving as an alternative to traditional in-person case conferences suspended during COVID-19. CPSolvers combines many known benefits of in-person case conferences with a compassionate and entertaining teaching style, plus advantages of the podcasting medium — democratizing morning report for listeners around the world.

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

“…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).…”

“…Two studies had international impact with learners globally using the morning report blog and The Clinical Problem Solvers podcast (Table 1). 54,25…”

“…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…”

Diagnostic Schemas: Form and Function

“…27 Although a schema-based approach to knowledge construction and problem solving has not been widely adopted in medical schools, schemas are being embraced by learners and teachers in digital education resources like podcasts and social media. 6,28…”

“…In recent years, the term "schema" has been increasingly used in clinical and educational settings. This adoption reflects the integration of cognitive psychology into clinical instruction, 1 as well as the influence of textbooks, 2 medical educators, 3,4 case reports, 5 and digital media [6][7][8] that have introduced schemas into the clinical reasoning vernacular. In this paper, we explore how diagnostic schemas (hereafter referred to as "schemas") can serve as powerful tools for both teacher and learners.…”