• Anand D Jagannath, Brian Kwan, Daniel B Heppe, Albertine S Beard, Paul B Cornia, Tyler Albert, Azadeh Lankarani-Fard, Joel M Bradley, Michelle M Guidry, Matthew Tuck, Kathlyn E Fletcher, and Craig G Gunderson.
• From the University of California San Diego School of Medicine, San Diego, the Department of Medicine, University of Colorado School of Medicine, Denver, the Department of Medicine, University of Minnesota School of Medicine, Minneapolis, the University of Washington School of Medicine, Seattle, the David Geffen School of Medicine, Los Angeles, California, the Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, the Tulane University School of Medicine, New Orleans, Louisiana, the George Washington University School of Medicine, Washington, DC, the Medical College of Wisconsin, Milwaukee, and the Yale University School of Medicine, West Haven, Connecticut.
• South. Med. J. 2022 Jul 1; 115 (7): 400-403.

ObjectivesMorning report is one of the central activities of internal medicine residency education. The two most common morning report formats are scripted reports, which use preselected cases with prepared didactics, and unscripted reports in which a case is discussed without preparation. No previous study has compared these two formats.MethodsWe conducted a prospective observational study of morning report conducted at 10 academic medical centers across the United States.ResultsA total of 198 case-based morning reports were observed. Of these, 169 (85%) were scripted and 29 (15%) were unscripted. Scripted reports were more likely to present a case with a known final diagnosis (89% vs 76%, P = 0.04), use electronic slides (76% vs 52%, P = 0.01), involve more than 15 slides (55% vs 3%, P < 0.001), and reference the medical literature (61% vs 34%, P = 0.02), including professional guidelines (32% vs 10%, P = 0.02) and original research (25% vs 0%, P = 0.001). Scripted reports also consumed more time in prepared didactics (8.0 vs 0 minutes, P < 0.001). Unscripted reports consumed more time in case history (10.0 vs 7.0 minutes, P < 0.001), physical examination (3.0 vs 2.0 minutes, P = 0.06), and differential diagnosis (10.0 vs 7.0 minutes, P = 0.01).ConclusionsMost contemporary morning reports are scripted. Compared with traditional unscripted reports, scripted reports are more likely to involve a case with a known diagnosis, use extensive electronic presentation slides, and consume more time in didactics, while unscripted reports consume more time in the early diagnostic process, including history, physical examination, and differential diagnosis. Residency programs interested in emphasizing these aspects of medical education should encourage unscripted morning reports.

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