Around the World in 60 Minutes: How a Virtual Morning Report has Created an International Community for Clinical Reasoning and Medical Education

Abstract

Problem: Traditionally, clinical reasoning is developed with purposeful exposure to clinical problems through case-based learning and clinical reasoning conferences that harvest a collaborative exchange of information in real-life settings. While virtual platforms have greatly expanded access to remote clinical learning, case-based clinical reasoning opportunities are scarce in low and middle income countries. Intervention: The Clinical Problem Solvers (CPSolvers), a nonprofit organization focused on clinical reasoning education, launched Virtual Morning Report (VMR) during the COVID-19 pandemic. VMR is an open-access, case-based clinical reasoning virtual conference on the Zoom platform modeled after an academic morning report format available to participants worldwide. The authors conducted 17 semi-structured interviews with CPSolvers’ VMR participants from 10 different countries to explore the experiences of the international participants of VMR. Context: The CPSolvers was founded by US physicians and has now expanded to include international members throughout all levels of the organization. VMR is open-access to all learners. Preliminary survey data collected from VMR sessions revealed 35% of the attendees were from non-English speaking countries and 53% from non US countries. Impact: Analysis generated four themes that captured the experiences of international participants of VMR: 1) Improving clinical reasoning skills where participants had little to no access to this education or content; 2) Creating a global community from a diverse, safe, and welcoming environment made possible by the virtual platform; 3) Allowing learners to become agents of change by providing tools and skills that are directly applicable in the setting in which they practice medicine; 4) Establishing a global platform, with low barriers to entry and open-access to expertise and quality teaching and content. Study participants agreed with the themes, supporting trustworthiness. Lessons Learned: Findings suggest VMR functions as and has grown into a global community of practice for clinical reasoning. The authors propose strategies and guiding principles based on the identified themes for educators to consider when building effective global learning communities. In an interdependent world where the virtual space eliminates the physical boundaries that silo educational opportunities, emphasis on thoughtful implementation of learning communities in a global context has the potential to reduce medical education disparities in the clinical reasoning space and beyond.

Keywords:

• clinical reasoning
• medical education
• virtual learning
• communities of practice

Acknowledgments

The authors thank Bridgette O’Brien, PhD (University of California, San Francisco), for review and thoughtful comments on prior versions of the manuscript. Dr. O’Brien was not compensated. Authors would also like to thank the team members of The Clinical Problem Solvers for their help and support in this endeavor. With heavy hearts, we would also like to acknowledge the loss of our friend and author, Rafael Medina, whose contributions to CPSolvers and VMR will forever resonate within the words of this manuscript.

Disclosure statement

The authors KL, MA, RM and SN are team members of the CPSolvers but are not founding members and receive no compensation from the CPSolvers. Their internal knowledge of the podcast may have influenced data interpretation. SB declares no conflicts of interest relevant to this work.

Contributions

KL participated in the study design, data collection (all interviews, all transcription) data analysis (dual coding and theme generation), and wrote substantial portions of the manuscript. MA completed data analysis (dual coding and theme generation) and wrote substantial portions of the manuscript. RM participated in manuscript drafting. SB participated in study design, data analysis (theme generation) and manuscript revisions. SN was the senior investigator and participated in study design, data analysis (theme generation) and manuscript revisions. All authors read and approved the final manuscript.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.