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矩阵形式在外科发病率和死亡率会议中的效用。

The utility of the matrix format for surgical morbidity and mortality conference.

作者信息

Bhalla Varun K, Boone Luke, Lewis Frank, Gucwa Angela L, Kruse E James

机构信息

Department of General Surgery, Georgia Regents University, Augusta, Georgia, USA.

出版信息

Am Surg. 2015 May;81(5):503-6.

Abstract

With the limitations posed by increasing work hour restrictions, surgical residency programs are focusing more on maximizing the educational benefit of their conferences. The Morbidity and Mortality (M&M) conference serves as a forum to discuss adverse events and patient care improvement using evidence-based medicine. The matrix format (MF) is an enhancement to the traditional format (TF), focusing on the case selection process and a postconference newsletter reiterating the relevant literature review and discussion points. Our institution adopted the MF to evaluate both its short- and long-term educational values. Surveys were distributed to residents and faculty within the Department of General Surgery to assess their interest and satisfaction, perception of educational value, and efficiency with the MF compared with the TF. Responses were obtained from 22/22 (100%) residents for the TF and 11/23 (48%) for the MF. Faculty responses were 19/19 (100%) and 9/16 (56%), respectively. Reasons for an overall decreased response with the MF were not investigated further, as participation was strictly voluntary. Our results confirmed an overall approval of the MF by both residents and faculty. Faculty reported an improved efficiency of the conference (P < 0.039), encompassing improved content and presentation quality. Residents reported an improved overall interest and satisfaction with the MF (P < 0.001) as well as an improvement in the educational value (P < 0.007). Residents spent less time preparing presentations and reported learning greater educational benefit to the conference when preparing their own presentations (P < 0.001). In conclusion, the MF resulted in a greater overall satisfaction for residents and attending surgeons with an increased investment by the audience and overall improvement in perceived educational benefit.

摘要

随着工作时间限制的增加带来的局限性,外科住院医师培训项目越来越注重最大化其会议的教育效益。发病率和死亡率(M&M)会议是一个使用循证医学讨论不良事件和改善患者护理的论坛。矩阵形式(MF)是对传统形式(TF)的改进,侧重于病例选择过程以及会后时事通讯,重申相关文献综述和讨论要点。我们的机构采用MF来评估其短期和长期教育价值。向普通外科部门的住院医师和教员发放了调查问卷,以评估他们的兴趣和满意度、对教育价值的认知以及与TF相比对MF的效率评价。对TF,22名住院医师中有22名(100%)回复;对MF,23名中有11名(48%)回复。教员的回复率分别为19名中的19名(100%)和16名中的9名(56%)。由于参与是严格自愿的,未进一步调查MF总体回复率下降的原因。我们的结果证实住院医师和教员总体上都认可MF。教员报告会议效率有所提高(P < 0.039),包括内容和展示质量的提高。住院医师报告对MF的总体兴趣和满意度有所提高(P < 0.001)以及教育价值有所提高(P < 0.007)。住院医师准备展示花费的时间更少,并且报告在准备自己的展示时从会议中学到了更大的教育益处(P < 0.001)。总之,MF使住院医师和主治外科医生总体满意度更高,受众投入增加,且感知到的教育效益总体有所改善。

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