title: Self- and rater-assessed effectiveness of "thinking-aloud" and "regular" morning report to intensify young physicians' clinical skills.
abstract: BACKGROUND
  This study compared the effects of the "thinking aloud" (TA) morning report (MR), which is characterized by sequential and interactive case discussion by all participants, with "regular" MR for clinical skill training of young physicians.
  
  
  METHODS
  Between February 2011 and February 2014, young physicians [including postgraduate year-1 (PGY1) residents, interns, and clerks) from our hospital were sequentially enrolled and followed for 3 months. The self- and rater-assessed educational values of two MR models for building up clinical skills of young physicians were compared.
  
  
  RESULTS
  The junior (intern and clerk) attendees had higher self-assessed educational values scores and reported post-training application frequency of skills trained by TA MR compared with the senior (PGY1 resident) attendees. Higher average and percentage of increased overall rater-assessed OSCE scores were noted among the regular MR senior attendees and TA MR junior attendees than in their corresponding control groups (regular MR junior attendees and TA MR senior attendees). Interestingly, regular MRs provided additional beneficial effects for establishing the "professionalism, consulting skills and organization efficiency" aspects of clinical skills of senior/junior attendees. Moreover, senior and junior attendees benefited the most by participating in seven sessions of regular MR and TA MR each month, respectively.
  
  
  CONCLUSIONS
  TA MR effectively trains junior attendees in basic clinical skills, whereas regular MR enhances senior attendees' "work reports, professionalism, organizational efficiency, skills in dealing with controversial and professional issues." Undoubtedly, all elements of the two MR models should be integrated together to ensure patient safety and good discipline among young physicians.
authors.affiliation: Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Hui-Chi
authors.initials: HC
authors.lastname: Hsu
authors.affiliation: Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Fa-Yauh
authors.initials: FY
authors.lastname: Lee
authors.affiliation: Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Clinical Skill Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC. Electronic address: yangyy@vghtpe.gov.tw.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Yang
authors.affiliation: Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Clinical Skill Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Yen-Po
authors.initials: YP
authors.lastname: Tsao
authors.affiliation: Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Wen-Shin
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chiao-Lin
authors.initials: CL
authors.lastname: Chuang
authors.affiliation: Division of General Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Ching-Chih
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Clinical Skill Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Division of Clinical Skill Training, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of Allergy-Immunology-Rheumatology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
authors.forename: Shung-Tai
authors.initials: ST
authors.lastname: Ho
mesh_terms: D000328:Adult; D002983:Clinical Competence; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male
keywords: basic clinical skills; morning report; thinking aloud