Virtual Morning Report: Perceived Impact on Learning and Wellbeing During the COVID-19 Pandemic

Introduction: The COVID-19 pandemic has severely affected medical training with social distancing requirements posing a barrier to in-person teaching and face-to-face interaction between medical students, residents, and attendings. It remains unknown whether a virtual learning format can effectively improve medical knowledge and decrease social isolation. The University of Hawaii Family Medicine Residency Program created a Virtual Morning Report (VMR) as a regular online gathering space and evaluated whether it improved clinical training and addressed social needs for learners and educators.

Objectives:
1. Evaluate the educational effectiveness of a virtual format for morning report.
2. Assess the impact of a virtual gathering space on wellbeing for learners and educators.
3. Identify participant preferences for online vs in-person format of educational sessions going forward.

Methods: Our community-based residency program hosted VMR 3 times weekly featuring interactive, case-based discussions (30 mins) facilitated by students, residents, and attendings. Attendance was voluntary and included community physicians. We administered an anonymous survey to measure participants’ improvement in medical knowledge and wellbeing. The survey instrument was developed by the authors and reviewed by resident and faculty stakeholders. A secondary outcome was participant preference for the future format of morning report.

Results: 21 residents, 10 students, and 5 attending physicians completed the survey (N = 37). Of the 37 participants (90% response), 87% reported that improving medical knowledge was a moderately or extremely important reason for attending VMR. Attending VMR resulted in perceived improvement of medical knowledge moderately or a great deal overall (78%), specifically in the areas of generating differential diagnoses (88%) and work-up (88%), but less so for history/exam skills (47%). With respect to impact on wellbeing, results were more mixed with 62% reporting improvement in wellbeing as an extremely or moderately important reason for attending VMR. The reported effect on social isolation from participants was less pronounced with just 30% reporting that VMR improved their overall wellbeing moderately or a great deal. When asked about specific areas of wellbeing, participants reported a greater degree of improvement in enjoyment of medicine (54%) and connecting with residents (57%) compared to connecting with faculty (44%) and increasing morale (38%). All participants expressed a preference for either a blended (78%) or entirely virtual (22%) format going forward.

Discussion: Participants reported perceived improvements in medical knowledge by attending Virtual Morning Report when COVID-19 restrictions reduced in-person teaching. While online socialization helped to improve wellbeing and increase a sense of connection for some participants, the majority did not report an improvement. A limitation of the study was that the components of wellbeing listed were chosen as the most relevant by the authors and other elements may be missing. Best practices for a successful VMR include hosting on a regular schedule, encouraging interactivity, focusing the teaching on key take-home points, and making the learning environment safe and fun. Given the strong preference for a completely virtual or blended format, more intentional efforts are needed to optimize online gathering to address the social and wellbeing needs of clinicians during this time of social isolation.

Target Audience: Medical educators and learners in any discipline at any level.