Faculty Collaboration Database

A Comparative Study of Scripted versus Unscripted Morning Reports: Results from a Prospective Multicenter Study. South Med J 2022 Jul;115(7):400-403

Date

07/02/2022

Pubmed ID

35777743

DOI

10.14423/SMJ.0000000000001411

Scopus ID

2-s2.0-85132808121 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

OBJECTIVES: Morning report is one of the central activities of internal medicine residency education. The two most common morning report formats are scripted reports, which use preselected cases with prepared didactics, and unscripted reports in which a case is discussed without preparation. No previous study has compared these two formats.

METHODS: We conducted a prospective observational study of morning report conducted at 10 academic medical centers across the United States.

RESULTS: A total of 198 case-based morning reports were observed. Of these, 169 (85%) were scripted and 29 (15%) were unscripted. Scripted reports were more likely to present a case with a known final diagnosis (89% vs 76%, P = 0.04), use electronic slides (76% vs 52%, P = 0.01), involve more than 15 slides (55% vs 3%, P < 0.001), and reference the medical literature (61% vs 34%, P = 0.02), including professional guidelines (32% vs 10%, P = 0.02) and original research (25% vs 0%, P = 0.001). Scripted reports also consumed more time in prepared didactics (8.0 vs 0 minutes, P < 0.001). Unscripted reports consumed more time in case history (10.0 vs 7.0 minutes, P < 0.001), physical examination (3.0 vs 2.0 minutes, P = 0.06), and differential diagnosis (10.0 vs 7.0 minutes, P = 0.01).

CONCLUSIONS: Most contemporary morning reports are scripted. Compared with traditional unscripted reports, scripted reports are more likely to involve a case with a known diagnosis, use extensive electronic presentation slides, and consume more time in didactics, while unscripted reports consume more time in the early diagnostic process, including history, physical examination, and differential diagnosis. Residency programs interested in emphasizing these aspects of medical education should encourage unscripted morning reports.

Author List

Jagannath AD, Kwan B, Heppe DB, Beard AS, Cornia PB, Albert T, Lankarani-Fard A, Bradley JM, Guidry MM, Tuck M, Fletcher KE, Gunderson CG

Author

Kathlyn E. Fletcher MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Diagnosis, Differential
Education, Medical
Humans
Prospective Studies
Teaching Rounds