Morning Report Tips, Tricks and Key Principles by LJCation 5/12/14

Morning report: Show and Tell for Clinician Educators. Telling a story, sharing the wealth. Role modeling.
Case selection: does not have to be a rare case. Just a good case that has some valuable teaching points.
Teaching points aka learning objectives: pick 2 or 3 things you want to get across. For example, exam
findings or key management principles. Remember, we have multiple levels of learners.
Your Preparation: you must prepare beforehand. Does not have to be hours and can focus on your
teaching points. Okay to say I dont know. Think about how you want to proceed during the discussion
part eg focus on imaging results then testing of Ddx. Guideline on prep time ~1 hour max.
Presenter Preparation: tell them the plan. Bring key data. Dont spill the beans.
Clinical Reasoning: very important to explain why you did things and how you worked through the case.
Teach them how to think through the case.
Time management: 11:30a to 12:00p. Start on time, end on time! get the Hx and Px on the board before
asking if any questions. Exception would be a case that focuses on exam findings what are you looking
for on physical exam? Okay to stop at Noon and not do any of your didactic slides (post to Dovenet)
Problem lists: essential and can free up your board space. Helps to frame the case and generate your
Ddx. Should be part of every morning report. Summary statements helpful: 35y F with new abd pain
Interactivity: Set the expectation. Ask questions, Priming, Redirection, Kudos, wrong answers; below
Asking questions: we encourage this if nobody is participating. Start at lowest appropriate level of
learner. For example, start with intern and move your way up to a second year. Also, us this when
somebody ask for a test why do you want an ESR?
Priming: Use this to stimulate participation. what would we expect to find on skin exam in this patient
with cirrhosis? or what would you expect to find on your LFTs?
Redirection: to stimulate participation. If a staff or somebody asks for a key test, Why did Dr Smith ask
for that test?
Wrong answers: be non-humiliating. Good thought but I usually think of obstructive pattern on LFTs
with pancreatic cancer or PBC makes me think of 50y F with pruritis and high Alk phos plus anti-
mitochondrial antibody positive.
Pathophysiology: encouraged. Why does this happen? Will help to lock it in and appeals to all levels.
Images: use them! Patient photos, Xray images, PBS, etc. Point out abnormal areas.
Differentials: use Meta-diagnosis (eg infection, neoplasia, rheumatologic, etc), testing principles
Management: risk/benefit/costs of certain therapies, efficacy/safety, complicaitons, prognosis
Didactics: limit these to 5 slides max. Key tables, figures, bulleted key points to summarize discussion.
Relate to your patients. Send to Cation for Dovenet uploading.
Cheat sheet: 1 or 2 pages with key table or outline of teaching points to help you remember.