Reframing morning report: Cognitive simulation in a safe space

Abstract

Background: Various purposes for morning report (MR), in addition to education, have been cited in the literature. Learners can find traditional MR challenging secondary to a perceived lack of psychological safety, the sense that they are being evaluated. Despite the recognition of unsafe learning environments, there is a paucity of literature on how to promote psychological safety in the MR setting. Approach: Our aim was to create an MR format utilizing scientifically proven teaching strategies to enhance its educational value. The creation of a safe learning environment was at the forefront of this initiative. Using Kern's six steps of curriculum development, we describe one institution's experience in reframing the morning report experience. Results: We conducted a pilot trial of the new MR with 35 paediatric residents beginning in July 2020 and followed the resident experience over 2 years. The primary outcome was attitudinal data as measured via a Likert scale. We found that by the second-year post-curricular implementation, greater than 50% of residents were less hesitant to participate in conference, increased their practice of retrieval and perceived feeling more prepared for examinations as the curriculum progressed. Implications: We believe the use of proven teaching strategies based in the cognitive psychology of learning can enhance the quality of education. Furthermore, we believe that central to the success of learning is the perception that the classroom is a safe space to be wrong. This model can serve as a steppingstone for institutions that look to improve their MR series.