Assistant Professor of Emergency Medicine and Pediatrics, Department of Emergency Medicine, Indiana University School of Medicine.
MedEdPORTAL. 2021 Oct 28;17:11190. doi: 10.15766/mep_2374-8265.11190. eCollection 2021.
The morbidity and mortality (M&M) conference has long been a part of the education of residents of all specialties in the United States, yet its structure is variable across training programs. Recent literature has described the use of M&M as a forum for education in quality improvement methodology; however, a structure focusing on education in cognitive biases and errors has not been previously described in .
This structured M&M conference series called upon resident presenters and peers in the audience to examine cognitive biases and errors involved in specific patient cases. Associated materials included preparatory guidelines provided to faculty advisors and resident presenters, a presentation template used during the introductory session, and a handout used during the discussion portions of presentations.
During the 2019-2020 academic year, a total of 24 PGY 2 pediatrics residents presented M&M cases. They identified a mean of 3.7 ( = 1.9) cognitive biases and/or errors per case and a mean of 1.7 ( = 0.7) debiasing strategies per case. Peers in the audience were also successful in identifying potential biases and errors at play during presentations.
We found that through this M&M conference structure, residents were able to demonstrate the ability to identify cognitive errors and biases both within themselves and in peers. This provided an effective forum for the identification and discussion of debiasing strategies, even when the series was forced to transition to a virtual format due to the COVID-19 pandemic.
在美国,发病率和死亡率(M&M)会议长期以来一直是所有专业住院医师培训的一部分,但它的结构在不同的培训项目中有所不同。最近的文献描述了将 M&M 用作质量改进方法学教育的论坛;然而,以前没有在 中描述过专注于认知偏差和错误教育的结构。
这个名为“结构化 M&M 会议系列”的会议要求住院医师主持人和观众中的同伴检查特定患者病例中涉及的认知偏差和错误。相关材料包括提供给教师顾问和住院医师主持人的预备指南、在介绍性会议期间使用的演示模板以及演示文稿讨论部分使用的讲义。
在 2019-2020 学年,共有 24 名儿科住院医师 2 年级学生展示了 M&M 病例。他们平均每例病例识别出 3.7 个( = 1.9)认知偏差和/或错误,平均每例病例识别出 1.7 个( = 0.7)去偏策略。观众中的同伴也成功地在演示过程中识别出潜在的偏见和错误。
我们发现,通过这种 M&M 会议结构,住院医师能够展示识别自身和同伴认知错误和偏差的能力。即使由于 COVID-19 大流行,该系列被迫转为虚拟形式,这也为识别和讨论去偏策略提供了一个有效的论坛。