Evaluation of a multifaceted "Resident-as-Teacher" educational intervention to improve morning report

All senior internal medicine residents were invited to participate in this study as teaching participants. All internal medicine residents and clerks were invited to participate as audience participants. The educational intervention included reading material, a small group session and feedback after teaching sessions. The educational and teaching experiences were rated prior to and three months after the intervention using questionnaires.Forty-six audience participants and 18 teaching participants completed the questionnaires. The degree to which morning report met the educational needs of the audience was higher after the educational intervention (effect size, d = 0.26, p = 0.01). The perceptions of the audience were that delivery had improved and that the sessions were less intimidating and more interactive. The perception of the teaching participants was that delivery was less stressful, but this group now reported greater difficulty in engaging the audience and less confidence in their medical knowledge.Following the educational intervention the audience's perception was that the educational experience had improved although there were mixed results for the teaching experience. When evaluating such interventions it is important to evaluate the impact on both the educational and teaching experiences as results may differ.Morning report is an integral part of most medical residency programs across North America. The format is typically a presentation of a recent clinical case and discussion of this case led by one or more residents with attending physicians, residents, and medical students participating in the case discussion. While originally implemented to help oversee the care of patients, the focus of morning report has more recently shifted towards education [1]. The impetus for change has been supported by surveys showing that residents feel education should be the primary purpose of morning report [2]. Indeed a recent survey of resident attitudes found that