Prince Jose M, Vallabhaneni Raghuveer, Zenati Mazen S, Hughes Steven J, Harbrecht Brian G, Lee Kenneth K, Watson Andrew R, Peitzman Andrew B, Billiar Timothy R, Brown Matthew T
Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Surg Educ. 2007 Sep-Oct;64(5):266-72. doi: 10.1016/j.jsurg.2007.06.007.
The Mortality and Morbidity (M&M) conference is a staple of surgical training programs. With reduced resident work hours, maximizing limited educational opportunities has become essential. We attempted to determine whether increasing the perceived educational value in M&M conference is associated with enhanced confidence levels in the future. We analyzed which features of M&M case reviews are associated with greater perceived educational value and enhanced confidence to deal with similar future clinical scenarios.
Educational process variables were prospectively collected for 47 consecutive cases reviewed over a 16-week period at a single institution's surgical M&M conference. General surgery residents completed self-reporting surveys rating the educational value of cases and impact on confidence in managing similar future clinical situations. Univariate regression analysis and multivariate regression analysis were calculated to study the relationship between various process variables and perceived educational and confidence values surveyed by residents.
Tertiary academic medical center.
General surgery residents PGY1 to PGY5.
Increased perceived educational value was associated with increased confidence (p < 0.001). Perceived educational value was increased with more questioning of the audience, increasing explanations of cases, use of slides, increase in number of questions directed to attendings, use of radiologic images, the more junior the resident surveyed, and when teaching points were made specifically for the medical students in attendance. (p < 0.05) Level of confidence was increased with increased questioning to the audience, increased explanations, increased questioning of the attendings, and more junior the resident surveyed. Increased questioning of presenter did not increase perceived educational value or resident perceived confidence value.
These data demonstrate that audience interaction, not directed questioning of the presenter, may improve surgical resident perceived educational value and confidence in managing problems discussed at M&M. These data suggest that M&M moderators can play a central role in maximizing audience interaction and improve the educational value of this important conference.
死亡率与发病率(M&M)会议是外科培训项目的一项重要内容。随着住院医师工作时长的减少,最大化有限的教育机会变得至关重要。我们试图确定提高M&M会议中感知到的教育价值是否与未来信心水平的提升相关。我们分析了M&M病例回顾的哪些特征与更高的感知教育价值以及应对未来类似临床情况的信心增强相关。
在一家机构的外科M&M会议上,对16周内连续回顾的47个病例前瞻性地收集教育过程变量。普通外科住院医师完成自我报告调查,对病例的教育价值以及对管理未来类似临床情况的信心影响进行评分。计算单变量回归分析和多变量回归分析,以研究各种过程变量与住院医师调查的感知教育和信心值之间的关系。
三级学术医疗中心。
普通外科住院医师PGY1至PGY5。
感知教育价值的增加与信心增强相关(p < 0.001)。当对观众提问更多、对病例解释增加、使用幻灯片、向主治医生提问数量增加、使用放射影像、接受调查的住院医师年资越低以及专门为在场医学生制定教学要点时,感知教育价值会增加。(p < 0.05)随着对观众提问增加、解释增多、对主治医生提问增加以及接受调查的住院医师年资越低,信心水平会提高。对报告人提问增加并不会提高感知教育价值或住院医师感知信心值。
这些数据表明,观众互动而非直接对报告人提问,可能会提高外科住院医师对M&M会议所讨论问题的感知教育价值和处理问题的信心。这些数据表明,M&M会议主持人在最大化观众互动以及提高这个重要会议的教育价值方面可以发挥核心作用。