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How to run a case: a guide for the resident at morning report
  1. Matthew Steven Krantz1,
  2. Benjamin Wade Frush2
  1. 1 Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  2. 2 Departments of Medicine and Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
  1. Correspondence to Matthew Steven Krantz, Division of Allergy, Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, 1161 21st Avenue South T-1218, MCN, Nashville, TN 37232-2650, USA; matthew.s.krantz{at}

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Teaching rounds have been completed, essential orders and consults have been placed and your pager has been turned in at the threshold of the morning report conference room. With an hour of respite from the wards, you will take part in the time-honoured tradition of morning report. You pour yourself a cup of coffee and strategically select a seat which might prevent you from being called upon. While you enjoy the social aspect of morning report, the prospect of being asked to lead a case causes anxiety and leads to a familiar but still uncomfortable sense of imposter syndrome.

As you settle in and seek to avoid eye contact with the chief resident, you sense him/her scanning the room for a willing participant. Despite your best efforts for avoidance, you hear your name called and immediately feel a pit in your stomach as you sense all the eyes in the room settle on you.


The above experience is an eminently relatable one for medical trainees. While this familiar sense of anxiety partially stems from the prospect of being asked to share one’s thinking aloud among peers and superiors, it is also likely the case that the lack of a systematic, tried-and-true approach to leading such case discussions contributes significantly to this discomfort.

It is curious that while much has been written on the topic of morning report—its anxiety-inducing ills as ‘morning distort’ and best practices for faculty and chief resident facilitators—none have attempted to provide a systematic approach to serving as a discussant for a case.1 2 Offering such an approach certainly would serve to help mitigate trainee anxiety at the prospect of being called upon, but more importantly might offer a framework to think systematically and comprehensively about patients one cares for in the future.

To this end, …

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  • Contributors MSK and BWF both contributed substantially to the conception of the work. MSK wrote the first draft, and both MSK and BWF critically revised and approved the final submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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