Abdelsattar Jad M, Mourany John, Afridi Faryal G, Musgrove Kelsey, Shaffer Linda, Khan Uzer, Marsh J Wallis, Borgstrom David C
Department of Surgery, West Virginia University, Morgantown, West Virginia.
Department of Surgery, West Virginia University, Morgantown, West Virginia.
J Surg Educ. 2020 Jul-Aug;77(4):905-910. doi: 10.1016/j.jsurg.2020.02.001. Epub 2020 Feb 24.
There exists significant variation in the approach to and execution of morbidity and mortality conference (M&MC). Faculty attendance remains a working challenge. We sought to change our department's M&MC and hypothesized improved educational value and attendance.
Complications were submitted in Clavien-Dindo format. A designated M&MC moderator facilitated discussion. A teaching point (TP) was assigned to each complication intended to be the focus of discussion. Presentations followed a structured 6-slide PowerPoint template. A web-based tool using Google Forms was developed and distributed as an "App" for tracking of attendance. An anonymous online survey was distributed to participants to elucidate perception of M&MC following the intervention.
Academic medical center.
Postgraduate year-1 to 5 surgery residents and faculty at West Virginia University, Morgantown.
Forty-eight of sixty-three surveys were returned (response rate 76%). Twenty-five faculty (70%) and 23 residents (82%) responded. A predetermined TP was viewed as the most favorable change made by both faculty and residents. 65% of faculty and residents acknowledged improved educational value, 58% found a single moderator to help streamline Morbidity and Mortality (M&M) presentations and 71% felt that a standard PowerPoint template improved quality of presentations. Both residents (96%) and faculty (68%) believed a predetermined TP improved the educational value of the conference and medical knowledge during preparation. More residents (43%) than faculty (16%) believed that changes to the department's M&MC format allowed better identification of quality improvement issues. Furthermore, the majority of residents (83%) believed that changes to the department's M&M format allowed better identification of system factors compared to faculty (32%), p = 0.003. Faculty participation increased from 60% to 80% after changes (p = 0.03).
The educational value of M&MC and attendance can be improved with simple changes, but faculty and residents may have different expectations and perceptions.
发病率和死亡率研讨会（M&MC）的开展方式和执行情况存在显著差异。教员的参与度仍是一项工作挑战。我们试图改变本部门的M&MC，并假设其教育价值和参与度会得到提高。
并发症以Clavien-Dindo格式提交。指定的M&MC主持人促进讨论。为每个并发症分配一个教学要点（TP），作为讨论的重点。演示文稿遵循结构化的6张幻灯片PowerPoint模板。开发了一个使用谷歌表单的网络工具，并作为一个“应用程序”分发，用于跟踪出勤情况。向参与者发放了一份匿名在线调查问卷，以阐明干预后对M&MC的看法。
学术医疗中心。
西弗吉尼亚大学摩根敦分校的一年级至五年级外科住院医师和教员。
63份调查问卷中有48份被收回（回复率7%）。25名教员（70%）和23名住院医师（82%）回复了问卷。预先确定的TP被视为教员和住院医师做出的最有利的改变。65%的教员和住院医师承认教育价值有所提高，58%的人发现单一主持人有助于简化发病率和死亡率（M&M）演示文稿，71%的人认为标准的PowerPoint模板提高了演示文稿的质量。住院医师（96%）和教员（68%）都认为预先确定的TP提高了会议的教育价值以及准备过程中的医学知识。认为本部门M&MC格式的改变能更好地识别质量改进问题的住院医师（43%）比教员（16%）更多。此外，与教员（32%）相比，大多数住院医师（83%）认为本部门M&M格式的改变能更好地识别系统因素，p = 0.003。改变后教员参与度从6%提高到80%（p = 0.03）。
通过简单的改变可以提高M&MC的教育价值和参与度，但教员和住院医师可能有不同的期望和看法。
