Morning report: Combining education with patient handover

Introduction: The advent of resident work hour restrictions has challenged us to train residents within a shorter working week, while ensuring continuity of patient care. We instituted morning report (MR) at the University of Virginia primarily as a means to accomplish these objectives. Serendipitously MR has become an integral educational tool for the surgical residents. The rationale for the format and instructional design are discussed in the context of learning theory. Methods: The chief residents as primary stakeholders were strongly encouraged to play a leadership role in designing MR. A facultyled didactic format was rejected because of the importance of focusing on resident team building, and leadership, but poor faculty participation was also an issue. Results: The initial obstacles included timing, and designing the format. Conclusions: MR is an opportunity for residents to exercise and improve their knowledge, leadership, presentation and problem-solving skills. We would hypothesise that the advantages for teaching are many and include that residents are prepared for actual clinical problems in a supportive environment with opportunities for immediate feedback and assessment. Reports of educational effectiveness of MR are mostly anecdotal and further studies are needed to characterise the types of learning and teaching that occur during MR and to document educational effectiveness.