Hands-on experience working directly with patients may be the best instructor for a medical student or trainee, but there are only so many hours in the day and so many patients that one can see. One method to expose Internal Medicine Residents to a greater variety of situations is the weekly Morning Report, organized and led by the Chief Residents.
One early morning last week, second-year resident Dr. Brenden Boyle presented a case in which an individual came through the Emergency Department with a perplexing personal history and an unusual recent event before admission. As Dr. Boyle reported, Dr. Sheena CarlLee guided the discussion, gauging reaction from the other residents in the room. Dr. CarlLee asked occasional follow-ups for clarification on why a resident might want to order a particular test or why their suspicions led in a certain direction. She also paused Dr. Boyle’s report to ask a resident to summarize what the room had learned at various points, ensuring that details were not slipping away from anyone.
Drs. Doug Hornick, Michi Goto, and Frank Abboud were also present to fill in any blanks or to offer a bit more perspective on the case being presented. As the discussion, both of what happened in Dr. Boyle’s case and in what others in the room might have done differently, Dr. CarlLee was careful to guide the discussion toward a final lesson. In this particular case, she noted that this particular instance might come up regularly for other residents. “This situation can be scary. Especially when you’re working overnight. Your impulse,” she cautioned, “might be to over-respond, but Brenden’s response was good here.”
In less than an hour, and one late-in-the-day email follow-up with more information, more than two dozen residents were able to benefit and learn from the experience of one of their colleagues. Under the Chiefs’ guidance, the residents were able to follow the same path and all walk away with the same lessons.