Abstract
Participation in case-based diagnostic reasoning (DR) conferences has previously been limited to those who can attend in-person. Technological advances have enabled these conferences to migrate to virtual platforms, creating an opportunity to improve access and promote learner participation. We describe the design and evaluation of virtual morning report (VMR), a novel case-based DR conference that aimed to expand access to these conferences, leverage a virtual platform to create new opportunities for learner participation, and improve learner confidence in performing DR. VMR took place on a videoconferencing platform. Participants included health professions students, post-graduate trainees, and practitioners. In designing VMR, we adapted concepts from the experience-based model of learning to design opportunities for learner participation. Teaching strategies were informed by information-processing and situativity theories. We evaluated learner experiences in VMR using a survey with open and closed-ended questions. Survey items focused on accessing case-based teaching conferences outside of VMR, participant perceptions of the educational value of VMR, and VMR's impact on participants' confidence in performing DR. We used thematic analysis to manually code open-ended responses and identify themes. 203 participants (30.2%) completed the survey. 141 respondents (69.5%) reported they did not otherwise have access to a DR conference. The majority of participants reported increased confidence performing DR. Respondents highlighted that VMR supplemented their education, created a supportive learning environment, and offered a sense of community. VMR can expand access to DR education, create new opportunities for learner participation, and improve learner confidence in performing DR.
Highlights
Case-based teaching conferences are consistently the highest rated curricular element of graduate medical training in internal medicine and are an important vehicle for teaching diagnostic reasoning (DR) to trainees. [1,2,3] there is limited evidence on the optimal design of and teaching strategies in these conferences, and participation has been limited to only those who can attend in-person. [1,2,3] Physical constraints to attendance are relevant because access to effective DR education continues to be a barrier to teaching this important clinical skill
Technological advances have enabled medical education to transition from physical to online spaces, [4, 5] and case-based conferences have migrated to virtual platforms. [6,7,8,9] This has created an opportunity to redesign and expand participation with the hope of improving DR education
Program Design In developing virtual morning report (VMR), we focused on three distinct elements of its design: conference structure, opportunities for learner participation, and facilitator teaching strategies
Summary
Case-based teaching conferences are consistently the highest rated curricular element of graduate medical training in internal medicine and are an important vehicle for teaching diagnostic reasoning (DR) to trainees. [1,2,3] there is limited evidence on the optimal design of and teaching strategies in these conferences, and participation has been limited to only those who can attend in-person. [1,2,3] Physical constraints to attendance are relevant because access to effective DR education continues to be a barrier to teaching this important clinical skill. [3] Recent studies of resident experiences in face-to-face morning reports highlighted impediments to learner attendance and participation, including the location of morning report, discomfort with contributing to case discussions by talking aloud, and not feeling knowledgeable enough to participate. [2]Technological advances have enabled medical education to transition from physical to online spaces, [4, 5] and case-based conferences have migrated to virtual platforms. [6,7,8,9] This has created an opportunity to redesign and expand participation with the hope of improving DR education. Technological advances have enabled medical education to transition from physical to online spaces, [4, 5] and case-based conferences have migrated to virtual platforms. In March 2020, The Clinical Problem Solvers (CPSolvers), a multimedia organization focused on teaching and learning DR, designed the first multi-institutional, virtual, case-based DR conference, known as virtual morning report (VMR). With virtual learning platforms playing an increasing role in medical education, educators need an understanding of how the design of and teaching during these conferences impacts learners. Technological advances have enabled these conferences to migrate to virtual platforms, creating an opportunity to improve access and learner participation. We describe the design and evaluation of virtual morning report (VMR), a novel case-based DR conference
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