Increased interactive format for Morbidity & Mortality conference improves educational value and enhances confidence

J Surg Educ. 2007 Sep-Oct;64(5):266-72. doi: 10.1016/j.jsurg.2007.06.007.


Objectives: The Mortality and Morbidity (M&M) conference is a staple of surgical training programs. With reduced resident work hours, maximizing limited educational opportunities has become essential. We attempted to determine whether increasing the perceived educational value in M&M conference is associated with enhanced confidence levels in the future. We analyzed which features of M&M case reviews are associated with greater perceived educational value and enhanced confidence to deal with similar future clinical scenarios.

Design: Educational process variables were prospectively collected for 47 consecutive cases reviewed over a 16-week period at a single institution's surgical M&M conference. General surgery residents completed self-reporting surveys rating the educational value of cases and impact on confidence in managing similar future clinical situations. Univariate regression analysis and multivariate regression analysis were calculated to study the relationship between various process variables and perceived educational and confidence values surveyed by residents.

Setting: Tertiary academic medical center.

Participants: General surgery residents PGY1 to PGY5.

Results: Increased perceived educational value was associated with increased confidence (p < 0.001). Perceived educational value was increased with more questioning of the audience, increasing explanations of cases, use of slides, increase in number of questions directed to attendings, use of radiologic images, the more junior the resident surveyed, and when teaching points were made specifically for the medical students in attendance. (p < 0.05) Level of confidence was increased with increased questioning to the audience, increased explanations, increased questioning of the attendings, and more junior the resident surveyed. Increased questioning of presenter did not increase perceived educational value or resident perceived confidence value.

Conclusions: These data demonstrate that audience interaction, not directed questioning of the presenter, may improve surgical resident perceived educational value and confidence in managing problems discussed at M&M. These data suggest that M&M moderators can play a central role in maximizing audience interaction and improve the educational value of this important conference.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Clinical Competence*
  • Competency-Based Education
  • Congresses as Topic / organization & administration*
  • General Surgery / education*
  • Humans
  • Internship and Residency / methods*
  • Logistic Models
  • Morbidity
  • Mortality
  • Multivariate Analysis
  • Self Efficacy
  • Teaching / methods