Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.
J Surg Educ. 2018 Nov;75(6):1535-1543. doi: 10.1016/j.jsurg.2018.05.010. Epub 2018 Jul 4.
Morbidity and mortality (M&M) conference is a mainstay of surgical education. However, its effectiveness is poorly described. The purpose of this study was to demonstrate the feasibility of a real-time audience response system for learner assessment during M&M.
We integrated a web-based audience response system into weekly M&M conference. First, this platform collected qualitative responses about the role of M&M. Then, we used the platform to direct questions to attendees in real time. Questions focused on surgical risk estimation and classifying root causes. Responses were grouped by training and compared to a validated risk tool's prediction. Root cause assignment concordance was statistically compared using Cohen's kappa between the pluralities of faculty responses to that of trainees.
General surgical residency program based at a tertiary academic medical center.
Affiliated categorical residents, preliminary residents, and clinical fellows.
We enrolled 110 participants (38 faculty, 31 senior trainees, and 41 trainees). The majority of respondents (75.9%) cited education as the purpose of M&M, and all of respondents stated education as their personal motivation. Audience response questions were integrated into 34 unique case presentations. Mean absolute differences between predicted complication rates and attendees' predictions were highest for faculty (-9.4%, p = 0.009) and lowest for junior residents (-1.8%, p = 0.385). When assigning root cause of each morbidity, concordance between faculty and trainees was low to moderate (K = 0.41).
Assessment of learning during M&M can be performed in real time with discrimination observed by learner experience level. These data support development of this response platform to trend learner performance over time and to monitor targeted educational interventions at future M&Ms.
发病率和死亡率（M&M）会议是外科教育的主要内容。然而，其效果描述得很差。本研究的目的是展示在 M&M 期间使用实时观众应答系统对学习者进行评估的可行性。
我们将基于网络的观众应答系统集成到每周的 M&M 会议中。首先，该平台收集了有关 M&M 作用的定性反馈。然后，我们使用该平台实时向与会者提问。问题集中在手术风险评估和分类根本原因上。根据培训情况对回答进行分组，并与经过验证的风险工具的预测进行比较。使用教师和学员回答的多数意见之间的 Cohen's kappa 统计比较根本原因分配的一致性。
位于三级学术医疗中心的普通外科住院医师培训计划。
附属分类住院医师、初级住院医师和临床研究员。
我们共纳入 110 名参与者（38 名教师、31 名高级住院医师和 41 名住院医师）。大多数受访者（75.9%）将教育作为 M&M 的目的，所有受访者都将教育作为他们的个人动机。应答问题被整合到 34 个独特的病例报告中。预测并发症发生率与参与者预测之间的平均绝对差异，教师最高（-9.4%，p=0.009），初级住院医师最低（-1.8%，p=0.385）。在分配每种发病率的根本原因时，教师和学员之间的一致性为低到中度（K=0.41）。
可以通过学习者经验水平来进行实时评估 M&M 中的学习情况。这些数据支持开发这种应答平台，以便随着时间的推移跟踪学习者的表现，并在未来的 M&M 中监测有针对性的教育干预措施。
