LAUSR

What problem was addressed? In 2015, the National Academies of Science, Engineering and Medicine called for enhanced education in clinical reasoning for all health care professionals. However, the best ways to teach clinical reasoning to trainees remain unclear. Historically, trainees enhanced their clinical reasoning skills through trial and error during clinical experiences and by savouring the sage advice of esteemed clinician educators. The lack of consistent, accessible resources in an era increasingly focused on diagnostic error is a concern for nearly all academic medical institutions. With today’s learners seeking highquality, efficient and portable resources, developing platforms that users will actively engage with is also essential in developing these skill sets. What was tried? We are using podcasts, now a wellestablished medium in the realm of medical education, to efficiently disseminate clinical reasoning tools in an innovative fashion. Morning Report (http://www.morningreport-podcast.com/) is an audio podcast of a clinical reasoning session akin to a standard case report. A clinical case is serially revealed to two expert physicians. The physicians then explicitly discuss their reasoning through the clinical case. A podcast moderator helps highlight and focus the listeners on the clinical reasoning process, specific concepts and clinical pearls. Since November 2017, over 25 episodes have been written, recorded, produced and distributed using the iTunes podcast application by faculty members, residents and students at Case Western Reserve University School of Medicine and University of Pittsburgh School of Medicine. To date, there have been nearly 7000 downloads from listeners across North America, Europe and Asia. Morning Report is an efficient and portable way to disseminate clinical reasoning concepts, with the capability of reaching thousands of listeners in a short amount of time, while allowing learners to analyse the case alongside the expert discussant. What lessons were learned? The goal of this podcast is to disseminate clinical reasoning tools using an example-based learning methodology and to stimulate active engagement with listeners. The podcast-based teaching modality has several advantages. First, the recordings provide opportunities for listeners to pause and critically assess problem representations and differential diagnoses. Second, listeners are encouraged to fill out assessment questions on the accompanying website and social media platforms, which stimulates recall and spaced repetition. Lastly, the digital platform can track number of downloads, popularity of topics and user comments, allowing for real-time guidance of content and delivery, which is an advantage over standard educational delivery systems. Some challenges that we encountered included organisation and logistics of recording sessions (e.g. times and locations for meeting with faculty members, fine-tuning recording paraphernalia, etc.) and effective distribution of podcast episodes to all interested audiences. In summary, this project successfully created an open-access clinical reasoning resource for medical trainees and demonstrates that podcasting is a feasible way to disseminate clinical reasoning concepts. The case-based teaching strategy with expert discussants allows for role modelling medical decision making and highlighting cognitive biases and metacognitive principles. Future projects will investigate the effectiveness of podcast delivery of clinical reasoning concepts on medical decision making.