Parasram Melvin, Loiseau Shamelia Y, Yoo Andrea S, Stone Jacqueline B, Ch'ang Judy H, Robbins Matthew S
From the Department of Neurology (M.P., S.Y.L., A.S.Y., J.H.C., M.S.R.), Weill Cornell Medicine, New York; and Department of Neurology (M.P., S.Y.L., A.S.Y., J.B.S.), Memorial Sloan Kettering Cancer Center, Manhattan, NY.
Neurol Educ. 2024 Mar 18;3(1):e200119. doi: 10.1212/NE9.0000000000200119. eCollection 2024 Mar.
Morning report (MR) has been a foundation of learning in many neurology residency programs. However, fortification of the high-yield learning points during MR cases may be achieved with supplementary educational initiatives to promote effective long-term retention and test-enhanced learning.
During the 2020-2021 academic year, chief residents of our neurology training program sought to implement neurology certification board-style multiple-choice questions (MCQs) based on cases presented at MR to enhance case-based learning.
A chief resident was selected weekly to write a MCQ based on an instructive case presented in MR from the prior week. The National Board of Medical Examiners item writing guide and online tutorial were used as guidelines for constructing MCQs. MCQs featured a clinical vignette in the question stem, and images were added to augment select cases. The MCQs were distributed using Qualtrics, which generated a web link and tracked anonymous answers. The Qualtrics link was added to the departmental weekly newsletter and labeled question of the week (QOW). Detailed explanations for each QOW were provided. A feedback survey was sent to the departmental education committee after study completion.
Forty MCQs were written by the chief residents, and 1 question was distributed weekly in the departmental newsletter. After week 24, the QOW was restructured to enhance visibility. The mean number of residents who completed the MCQ was 13 (of 29 neurology residents [range 4-29]). The overall median response rate was 38%. When stratified by weeks 1-24 and 25-40 to account for QOW reformatting, the median response rate for weeks 1-24 and weeks 25-40 were 24% and 55%, respectively ( = 0.0013). In a poststudy survey sent to the education committee, 90% of respondents felt that resident-created MCQs were similar to board-style questions and added educational value to resident learning.
A chief resident QOW initiative was feasible and led to neurology resident academic engagement and enrichment, which supplemented case-based learning through a test-enhanced learning approach. Resident participation was significantly increased with enhanced visibility of QOW in weekly emails compared with hyperlink format.
早间病例汇报（MR）一直是许多神经科住院医师培训项目学习的基础。然而，通过补充教育举措强化MR病例中的高价值学习要点，可能有助于促进长期有效记忆和测试强化学习。
在2020 - 2021学年，我们神经科培训项目的总住院医师试图根据MR中呈现的病例实施神经科认证委员会风格的多项选择题（MCQ），以加强基于病例的学习。
每周挑选一名总住院医师根据前一周MR中呈现的一个指导性病例编写一道MCQ。美国医学考试委员会的试题编写指南和在线教程被用作构建MCQ的指导。MCQ在题干中设有临床案例，并添加图片以辅助部分案例。这些MCQ通过Qualtrics进行分发，Qualtrics生成一个网页链接并跟踪匿名答案。该Qualtrics链接被添加到部门每周通讯中，并标记为每周问题（QOW）。同时提供了每个QOW的详细解释。研究结束后向部门教育委员会发送了一份反馈调查问卷。
总住院医师共编写了40道MCQ，每周在部门通讯中发布1道。在第24周之后，对QOW进行了重新调整以提高其可见性。完成MCQ的住院医师平均人数为13人（神经科住院医师共29人[范围为4 - 29人]）。总体中位数回复率为38%。按第1 - 24周和第25 - 40周分层以考虑QOW格式调整，第1 - 24周和第25 - 40周的中位数回复率分别为24%和55%（ = 0.0013）。在发送给教育委员会的一项研究后调查中，90%的受访者认为住院医师编写的MCQ与委员会风格的题目相似，并且为住院医师的学习增加了教育价值。
总住院医师发起的QOW举措是可行的，并且促使神经科住院医师参与学术活动并丰富了学习内容，通过测试强化学习方法补充了基于病例的学习。与超链接格式相比，通过在每周电子邮件中提高QOW的可见性，显著提高了住院医师的参与度。
