Ways M, Kroenke K, Umali J, Buchwald D
Department of Medicine, University of Washington, Seattle, USA.
Arch Intern Med. 1995 Jul 10;155(13):1433-7. doi: 10.1001/archinte.155.13.1433.
Morning report is a time-honored tradition of most internal medicine residency programs. Despite its ubiquity, residents' attitudes regarding morning report have not been investigated.
Using a 44-item questionnaire, we surveyed residents in an academic internal medicine training program working in five teaching hospitals on the processes of teaching and learning during morning report.
Among 74 residents completing the survey (100%), morning report was ranked as the most valuable of six educational activities. Residents preferred discussing new cases, with time equally divided between "great" cases and common problems, an interactive discussion with open-ended questions, and a Socratic teaching style. Seventy-two percent stated that attending physicians should be chosen from among the best teachers. General medical knowledge (90%), an ability to ask effective questions (86%), and good interpersonal skills (84%) were identified as the most important attending physicians' attributes. Discussions of basic science, use of anecdotes, and subspecialty knowledge were not considered highly desirable characteristics. Attending physicians with limited knowledge (41%) were viewed as the major obstacle to effective teaching while provocative attending physicians (52%) were considered as being most valuable to the learning experience.
Residents believed that the morning report was a valuable educational experience. They preferred clinically based, open-ended interactive discussions led by attending physicians with a broad knowledge base. These findings underscore the importance of morning report in general, and the role of attending physicians in particular, in medical education.
早间汇报是大多数内科住院医师培训项目由来已久的传统。尽管其普遍存在,但住院医师对早间汇报的态度尚未得到调查。
我们使用一份包含44个条目的问卷,对在五家教学医院工作的一个学术性内科培训项目中的住院医师进行了关于早间汇报期间教学与学习过程的调查。
在74名完成调查的住院医师(100%)中,早间汇报在六项教育活动中被评为最有价值的活动。住院医师更喜欢讨论新病例,时间在 “典型” 病例和常见问题之间平均分配,喜欢开放式问题的互动讨论以及苏格拉底式教学风格。72% 的人表示主治医生应该从最佳教师中挑选。一般医学知识(90%)、提出有效问题的能力(86%)和良好的人际沟通技巧(84%)被认为是主治医生最重要的特质。对基础科学的讨论、轶事的运用和亚专业知识不被视为非常理想的特征。知识有限的主治医生(41%)被视为有效教学的主要障碍,而具有启发性的主治医生(52%)被认为对学习体验最有价值。
住院医师认为早间汇报是一次有价值的教育经历。他们更喜欢由知识渊博的主治医生主持的基于临床的开放式互动讨论。这些发现强调了早间汇报总体上的重要性,尤其是主治医生在医学教育中的作用。