Seigel Todd A, McGillicuddy Daniel C, Barkin Adam Z, Rosen Carlo L
Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA.
J Emerg Med. 2010 May;38(4):507-11. doi: 10.1016/j.jemermed.2008.09.018. Epub 2009 Feb 6.
Morbidity and Mortality conferences (M&M) are used to meet many of the Core Competencies required by the Accreditation Council of Graduate Medical Education for residency training programs. This study seeks to describe and quantify different types of M&M conferences among Emergency Medicine (EM) training programs.
A confidential survey was e-mailed to the Program Directors (PD) or Assistant PD of all United States (US) Emergency Medicine residency training programs with functional e-mail addresses listed in the Society for Academic Emergency Medicine residency catalog. Descriptive statistics and 95% confidence (CI) intervals are reported.
Of 124 surveys sent out, 89 (72%) completed surveys were returned. There were 88 programs (99%, CI 93-100%) that reported having an M&M. Conferences are held monthly at 67% (CI 57-76%) of programs. Cases for discussion are identified by an EM attending, quality assurance committee, or resident (70%, 57%, and 48%, respectively). Half of programs reported that > 40% of the cases involve systems errors. Twenty percent of programs report that > 40% of the cases involve deaths. Consultants are invited at 44% of programs, and 20% of programs specifically invite radiologists. If a medical error is identified in the M&M, 79% (70-86%) of programs have a protocol for addressing the error.
EM training programs almost uniformly have an M&M, but these conferences vary in frequency, content, and attendance. Future studies are needed to investigate resident and faculty perceptions of M&M, its educational impact, and ways to improve the conference.
发病率与死亡率研讨会（M&M）用于满足毕业后医学教育认证委员会对住院医师培训项目所要求的许多核心能力。本研究旨在描述并量化急诊医学（EM）培训项目中不同类型的M&M研讨会。
向所有美国急诊医学住院医师培训项目的项目主任（PD）或助理PD发送了一份保密调查问卷，这些项目的有效电子邮件地址列在学术急诊医学协会住院医师名录中。报告描述性统计数据和95%置信区间（CI）。
共发出124份调查问卷，收回89份（72%）完成的调查问卷。有88个项目（99%，CI 93 - 100%）报告举办了M&M研讨会。67%（CI 57 - 76%）的项目每月举办研讨会。讨论的病例由急诊医学主治医生、质量保证委员会或住院医师确定（分别为70%、57%和48%）。一半的项目报告称，超过40%的病例涉及系统错误。20%的项目报告称，超过40%的病例涉及死亡。44%的项目邀请了顾问，20%的项目特别邀请了放射科医生。如果在M&M研讨会上发现医疗差错，79%（70 - 86%）的项目有处理该差错的方案。
急诊医学培训项目几乎都举办M&M研讨会，但这些研讨会在频率、内容和参与人员方面存在差异。未来需要开展研究，调查住院医师和教员对M&M研讨会的看法、其教育影响以及改进研讨会的方法。
