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Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review

Luke Y.C. Chen, Tien T.T. Quach, Riki Dayan, Dean Giustini and Pim W. Teunissen
May 09, 2023 11 (3) E411-E425; DOI: https://doi.org/10.9778/cmajo.20210203
Luke Y.C. Chen
Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
MD MMEd
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Tien T.T. Quach
Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
MSc
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Riki Dayan
Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
MD
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Dean Giustini
Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
MLS MEd
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Pim W. Teunissen
Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
MD PhD
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  • Figure 1:
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    Figure 1:

    PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram of study identification and selection process. Note: CBE = classroom-based education, ERIC = Education Resources Information Center, PGME = postgraduate medical education.

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    Figure 2:

    Number of included studies (n = 94) published from 1996 to 2022.

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    Table 1:

    Studies focusing on “experiences”

    Author, yearJournalCountryLocationDiscipline(s)ParticipantsDesignStudy topicDescription, justification or clarification
    Acosta et al., 2014 (34)Postgraduate Medical JournalUSAUniversity of FloridaInternal medicine67 residentsPre- and post-intervention questionnaireClinical approach to obesityDescription
    Al Achkar et al., 2018 (35)BMC Medical EducationUSAWashington and IndianaNumerous233 of 1757 program directorsSurvey studyInterprofessional education in PGMEDescription
    Albert et al., 2021 (36)Journal of General Internal MedicineUSA10 centres in USAInternal medicine497 residentsSurvey studyResident perceptions of morning reportDescription
    Anderson et al., 2021 (37)Journal of Surgical EducationUSAUniversity of California, DavisSurgery129 US surgical programsSurvey studySurgeon perceptions of morbidity and mortality roundsDescription
    Audcent et al., 2013 (38)PediatricsCanadaOttawaPediatrics125 traineesMixed methodsGlobal child health modulesDescription
    Bansal et al., 2018 (39)Postgraduate Medical JournalUSAState University of New YorkPediatrics34 residentsSurvey studyResident module on insulin pumpsDescription
    Barnwell et al., 2017 (40)Journal of Surgical EducationUSAWake Forest UniversityOrthopedicsSurvey of 24 residentsSurvey studyCase-based v. traditional lecturesDescription
    Barrett et al., 2021 (41)MedEdPortalUSAEmory UniversityDermatologyNot specifiedDescriptive studyEducational module on diversity and sexualityDescription
    Bowman et al., 2015 (43)Clinical TeacherUSAUniversity of MinnesotaInternal medicine57 residentsSurvey studyTeaching high-value care in morning reportDescription
    Brown et al., 2018 (44)International Urology and NephrologyCanadaUniversity of OttawaNephrologyNot specifiedDescriptive studyMorbidity and mortality rounds in renal diseaseDescription
    Butler et al., 2017 (45)Family MedicineUSAUSA (numerous)Family medicine291 of 441 programs surveyedSurvey studySurvey of family medicine didactic teachingDescription
    Chalk et al., 2004 (46)Canadian Journal of Neurological SciencesCanadaMcGill UniversityNeurology21 program directorsSurvey studyOverview of AHD in Canadian neurology programsDescription
    Clay et al., 2016 (47)Critical Ultrasound JournalUSAOregon Health & Science University, PortlandInternal medicine33 residentsPre- and post-intervention test scoresUltrasound skills in critical careDescription
    Cosimini et al., 2016 (48)Medical EducationUSAUniversity of Southern CaliforniaPediatrics36 conferences and 1043 resident arrivalsRetrospective studyEffect of food on attendance at NCsDescription
    Denizard-Thompson et al., 2018 (49)MedEdPortalUSAWake ForestInternal medicine and family medicine25 internal medicine, 36 family medicine residentsSurvey studyMusculoskeletal module for residentsDescription
    Di Genova et al., 2015 (50)Paediatric and Child HealthCanadaMcGillPediatrics14 pediatrics residentsSurvey studyAHD redesign, focus on CanMEDS rolesDescription
    Dreyer et al., 2014 (31)World Journal of SurgeryScotland and ZambiaDumfries and ZambiaGeneral surgery13 faculty, 24 residentsMixed methodsSurgical emergencies course for African programsDescription
    Durning et al., 2003 (51)Teaching and Learning in MedicineUSAUniformed Services UniversityInternal medicineNumerousMixed methodsComparing morning report content to curricular guidelinesDescription
    Fraser et al., 2016 (89)Journal of Graduate Medical EducationUSAHarvard Medical SchoolInternal medicine153 residentsSurvey studyNC effectiveness and impact on self-studyJustification
    Hill et al., 2000 (52)Family MedicineUSAUS residency programsFamily medicine278 programsSurvey studyStudy of conference format in family medicineDescription
    Juo et al., 2019 (53)Journal of Surgical EducationUSAUniversity of California, Los AngelesGeneral surgery8 faculty, 32 traineesSurvey studyMedical malpracticeDescription
    Kavanagh et al., 2017 (54)Academic PsychiatryUSAColumbiaPsychiatry144 residentsSurvey studyPsychopharmacology-prescribing workshopsDescription
    Klein et al., 2008 (55)Canadian Family PhysicianCanadaUniversity of AlbertaFamily medicineNot specifiedMixed methodsAcademic conferences and impact on self-studyDescription
    Ksouri et al., 2010 (27)American Journal of Critical CareFranceUniversité Paris-DescartesCritical care260 deathsMixed methods, descriptive studyEducational impact of morbidity and mortality roundsDescription
    Logan et al., 2021 (56)MedEdPortalUSAUniversity of California, San FranciscoInternal medicine35 residentsSurvey studyVirtual case series module for clinical reasoningDescription
    Marchalot et al., 2017 (28)Anaesthesia Critical Care and Pain MedicineFranceUniversity of RouenAnesthesia308 residentsPre–post studyTraditional v. flipped classrooms in anesthesiaJustification
    Mickelson et al., 2009 (57)Canadian Urology Association JournalCanadaUniversity of British ColumbiaUrologyNot specifiedDescriptive studyImplementation of adult learning principlesDescription
    Mishra et al., 2013 (97)UrologyUSACleveland ClinicUrology8 fellows, 24 residentsSurvey studySurveys on a new electronic caseJustification
    Naumberg et al., 1997 (59)Academic MedicineUSAUniversity of Rochester, NYFamily medicineProgram directorsSurvey studyEarly description of AHDsDescription
    Pembroke et al., 2018 (62)Practical Radiation OncologyCanadaMcGill UniversityRadiation oncology6 residentsMixed methodsQuality improvementDescription
    Pentiuk et al., 2012 (63)J Pediatric Gastroenterology & NutritionUSACincinnati Children’s Medical CentrePediatrics31 residentsSurvey studyGastroenterology fellows as teachers programDescription
    Pereira et al., 2008 (64)Palliative MedicineCanadaUniversity of CalgaryRural family medicine36 residentsSurvey studyPalliative careDescription
    Randall et al., 2020 (100)American J Medical SciencesUSAUniversity of FloridaInternal medicine95 residentsSurvey studyResident well-beingJustification
    Richardson et al., 2018 (65)Teaching and Learning in MedicineUSAVanderbiltCardiology22 cardiology fellowsSurvey studyGuidelines adherence sessionsDescription
    Ritchie et al., 2018 (111)Medical Science EducatorUSAUniversity of ColoradoPediatrics12 facultyFocus group studyFaculty perspectives of AHDClarification
    Robbins et al., 2018 (66)SurgeryUSAUniversity of WisconsinVascular surgery4 trainees and 4 facultySurvey studyTransition from NC to AHDDescription
    Salib et al., 2015 (67)Southern Medical JournalUSAUniversity of Texas at AustinInternal medicineNot specifiedSurvey studyCommunication skills workshopDescription
    Salib et al., 2018 (68)Southern Medical JournalUSAUniversity of Texas at AustinInternal medicine50 residentsSurvey studyBusiness of medicineDescription
    Sawatsky et al., 2014 (112)Journal of Graduate Medical EducationUSAUniversity of PittsburghInternal medicine41 residentsFocus group studyLearning preferences in NCClarification
    Sawatsky et al., 2015 (69)Medical Education OnlineUSAUniversity of PittsburghInternal medicine20 facultyFocus group studyChallenges to active learning in conferencesDescription
    Schynoll et al., 2018 (70)Journal of Graduate Medical EducationUSAAlbany Medical CollegeInternal medicine64 faculty, 89 residentsSurvey of faculty and residentsTeam-based learningDescription
    Shaffer et al., 2017 (71)Clinical TeacherUSAStanford UniversityNumerous78 residentsSurvey studyPractice transition modulesDescription
    Shifflette et al., 2012 (72)Journal of Surgical EducationUSAMethodist Dallas Medical CenterGeneral surgery26 program directorsSurvey studyJournal clubs in surgery programsDescription
    Smith et al., 2016 (73)Journal of Graduate Medical EducationUSAUniversity of WisconsinRespirology, hematology/oncology, cardiology46 fellowsRandomized crossover studyEffect of paging reminders on attendance at conferenceDescription
    Solbach-Sabbach et al., 2019 (74)Education for HealthIsraelTechnion: Israel Inst. of TechnologyFamily medicine56 residentsMixed methodsResident research skillsDescription
    Stiles et al., 2006 (75)Current SurgeryUSAUniversity of VirginiaGeneral surgery25 residentsSurvey studyMorning reportDescription
    Stokes et al., 2017 (33)Canadian Medical Education JournalCanada and GuyanaUniversity of Calgary; University of GuyanaInternal medicine191 (Guyana) and 16 (Calgary) residentsSurvey studyCalgary and Guyana videoconference sessionsDescription
    Tam et al., 2017 (76)MedEdPortalCanadaHospital for Sick ChildrenPediatrics28 residentsSurvey studyPediatric limb pain moduleDescription
    Tanaka et al., 2016 (77)Anesthesiology Research and PracticeUSAStanford UniversityAnesthesiology131 residentsSurvey studyShort daily lectures in anesthesiaDescription
    Tarabichi et al., 2018 (78)Journal of Surgical EducationUSARutgers UniversityGeneral surgeryNot specifiedPre- and post-test resultsKnowledge from assigned reading and lecturesDescription
    Theophanous, et al., 2021 (79)Medical EducationUSAChicagoPediatrics and other specialtiesNot specifiedDescriptive studyResidents as teachersDescription
    Thomas et al., 2005 (80)Teaching and Learning in MedicineUSAMayo ClinicInternal medicine20 residentsPre- and post-test resultsConference attendance and test scoresDescription
    Wong et al., 2009 (81)BMC Medical EducationCanadaUniversity of British ColumbiaInternal medicine64 residentsSurvey studyCommunication skills workshopDescription
    Zanotti et al., 2019 (82)Journal of Graduate Medical EducationUSAUniversity of ChicagoGynecologyGynecology fellowsMixed methodsValue-based careDescription
    Zeller et al., 2015 (92)Southern Medical JournalCanadaMcMaster UniversityInternal medicine31 residentsMixed-methods studyAnatomy module for learning bone marrow biopsiesDescription
    • Note: AHD = academic half day, NC = noon conference, PGME = postgraduate medical education.

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    Table 2:

    Studies focusing on “trajectories”

    Author, yearJournalCountryLocationDiscipline(s)ParticipantsDesignStudy topicDescription, justification or clarification
    Armson et al., 2021 (84)Family MedicineUSAUniversity of CalgaryFamily medicine139 residentsFocus group studyResident perceptions of small-group learning in AHDJustification
    Batalden et al., 2013 (109)Academic MedicineUSAHarvard, Cincinnati, Cornell NYInternal medicineNot specifiedQualitativeTransition from NC to AHDClarification
    Cacamese et al., 2004 (85)Medical TeacherUSAJohns Hopkins UniversityInternal medicine13 residentsPre- and post-test resultsEffect of conference attendance on test scoresJustification
    Eid et al., 2015 (86)BMC Medical EducationUSAMD Anderson Cancer CenterHemotology and oncologySurvey, interviewsMixed methodsEffectiveness of transition from NC to AHDJustification
    Fitzgerald et al., 2003 (87)Academic MedicineUSAUniversity of California, Los AngelesInternal medicine81 residentsCross-sectionalExamine association between resident attendance and examination scoresJustification
    Franklin et al., 2017 (88)Journal of Pediatric OrthopaedicsUSAPittsburgh and HamotOrthopedics196 residentsPre- and post-intervention test scoresEffect of pediatric teaching module on in-training examination scoresJustification
    Gene Hern et al., 2009 (90)Academic Emergency MedicineUSA4 US emergency medicine programsEmergency medicine405 residentsAttendance and test resultsConference attendance and test scoresJustification
    Goyal et al., 2019 (91)Diagnosis (Berlin)USAJohns Hopkins UniversityInternal medicineNot specifiedPilot study, descriptiveDescription of a focused morning-report format for internsJustification
    Ha et al., 2014 (11)Journal of Graduate Medical EducationUSACleveland ClinicInternal medicine364 residentsPre- and post-test resultsTransition from NC to AHD: results of in-training examination scores and surveys of learning satisfaction before and afterJustification
    House et al., 2017 (92)AEM Education & TrainingUSAChildren’s Hospital of PennsylvaniaPediatrics122 residentsRandomized crossover studySpaced education as an adjunct to traditional education effect on test scoresJustification
    Limvorapitak et al., 2016 (30)J Medical Assoc ThailandThailandThammasat UniversityInternal medicine19 residentsCross-sectionalTest scores in internal medicineJustification
    Lin et al., 2018 (32)Journal of Surgical EducationUSA and RwandaColorado, Harvard, KigaliSurgery, anesthesia, obstetrics55 residentsSurvey studySurgical safety program run by American surgery programs for a residency program in Kigali, RwandaDescription
    McDonald et al., 2007 (93)Journal of General Internal MedicineUSAMayo ClinicInternal medicine195 residentsCross-sectionalTest scores in internal medicineJustification
    McDonald et al., 2008 (94)Mayo Clinic ProceedingsUSAMayo ClinicInternal medicine195 residentsCross-sectionalExamine association of conference attendance with internal medicine in-training examination scoresJustification
    Mehta et al., 2018 (95)Journal of Surgical EducationUSAUniversity of UtahPlastic surgery8 residentsPre- and post-intervention test scores90-min weekly didactic sessions and their impact on test scoresJustification
    Meyer et al., 2018 (96)Academic RadiologyUSAMichigan MedicineRadiology54 residentsCross-sectionalConference attendance and test scoresJustification
    Moreno et al., 2013 (58)Journal of Graduate Medical EducationUSAUniversity Wisconsin–MadisonPediatrics70 residentsPre- and post-surveyEliminated NC and implemented a new block formatDescription
    Ozuah et al., 2001 (60)Archives of Pediatrics & Adolescent MedicineUSAAlbert Einstein CollegePediatrics80 residentsCohort studyNo impact of problem-based learning impact on self-directed learningDescription
    Parikh et al., 2008 (61)American Journal of SurgeryUSAUniversity of California, Los AngelesGeneral surgery60 residentsSurvey studyDescription of new structures lecturesDescription
    Picciano et al., 2003 (98)Family MedicineUSAJFK Medical CenterFamily medicine20 residentsCohort studyEffectiveness of NCs for increasing residents’ knowledge for both short term (1 mo) and long term (7 mo)Justification
    Raman et al., 2010 (99)Medical TeacherCanadaUniversity of Calgary and University of TorontoGastroenterology fellows10 (Calgary) + 10 (Toronto) gastroenterology fellowsProspective cohort studyComparison of AHD v. dispersed in a nutrition courseJustification
    Riddell et al., 2017 (101)Journal of Graduate Medical EducationUSAUniversity of California, San Francisco–Fresno, San Fran General, University of Southern CaliforniaEmergency medicine73 residentsRandomized crossover studyTraditional v. flipped classroom in emergency medicineJustification
    Rose et al., 2016 (102)Journal of Emergency MedicineUSAUniversity of Southern CaliforniaEmergency medicine17 residentsPre- and post-intervention test scoresTraditional v. flipped classroomJustification
    Rucker et al., 2017 (103)Advances in Medical Education and PracticeUSAIndiana and WashingtonFamily medicineNot specifiedDescriptive studyEvidence-based medicine and technological literacyJustification
    Sawatsky et al., 2014 (104)BMC Medical EducationUSAUniversity of PittsburghInternal medicine69 residents; 4 facultySurvey studySurveys and test scores after implementation of active learningJustification
    Volerman et al., 2019 (105)BMC Medical EducationUSAUniversity of ChicagoPediatrics47 students and residentsSurvey studyTeam-based learningJustification
    Winter et al., 2007 (106)Family MedicineUSAJFK Medical Center and Rutgers Univ.Family medicine17 residentsPre- and post-test score resultsNC attendance and test scoresJustification
    Zastoupil et al., 2017 (107)Academic PediatricsUSAUniversity of ColoradoPediatricsNot specifiedMixed methodsTransition from NC to AHDsJustification
    Zweifler et al., 1996 (108)Academic MedicineUSASan Francisco, Colorado, U. WashingtonFamily medicineNot specifiedDescriptive studyFirst description of AHDsJustification
    • Note: AHD = academic half day, NC = noon conference.

    • View popup
    Table 3:

    Studies focusing on “reifications”

    Author, yearJournalCountryLocationDiscipline(s)ParticipantsDesignStudy topicDescription, justification or clarification
    Bhatt-Mackin et al., 2017 (42)Academic PsychiatryUSADuke UniversityPsychiatryNot specifiedDescriptive studyProtecting time for faculty developmentDescription
    Chen et al., 2017 (7)Medical TeacherCanadaUniversity of British ColumbiaFamily medicine30 residents and facultyQualitative case studyProfessional identity formationClarification
    Chen et al., 2015 (3)Academic MedicineCanadaUniversity of British ColumbiaOrthopedics, internal medicine and hematology27 residentsQualitative case studyRole of AHD in resident educationClarification
    Gregor et al., 2016 (110)Teaching and Learning in MedicineCanadaUniversity of Toronto and Queen’s UniversityNot specificNot specifiedCritical literature synthesisPurpose of morbidity and mortality roundsClarification
    Peters et al., 2018 (29)Teaching and Learning in MedicineNetherlandsUniversity of LeuvenGeneral practice25 trainees, 11 faculty, 18 workplace supervisorsTransfer of learningTransfer of learning during internshipClarification
    Wagoner et al., 2019 (115)Teaching and Learning in MedicineUSAUniversity of ColoradoPediatrics12 facultySurvey studyAttending physician perspectives on AHDClarification
    • Note: AHD = academic half day.

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CMAJ Open: 11 (3)
Vol. 11, Issue 3
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Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review
Luke Y.C. Chen, Tien T.T. Quach, Riki Dayan, Dean Giustini, Pim W. Teunissen
May 2023, 11 (3) E411-E425; DOI: 10.9778/cmajo.20210203

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Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review
Luke Y.C. Chen, Tien T.T. Quach, Riki Dayan, Dean Giustini, Pim W. Teunissen
May 2023, 11 (3) E411-E425; DOI: 10.9778/cmajo.20210203
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