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Training Level

Resident PGY 3


Henry Ford Hospital


Introduction: Morbidity and mortality (M&M) conference has long been a vital educational tool for medical students, residents, and staff. It allows for learning and quality improvement through discussion of noteworthy cases. There is, however, a paucity of data on the how M&M is perceived by medical students, especially as a function of their interest, or lack thereof, in surgery. The objective of this study was to fill this void by measuring the perceptions of medical students regarding M&M conference.Methods: Medical students in a single medical school class voluntarily took part in a survey after their surgical rotation. The survey gauged students’ interest in surgery as a career and their overall rating of M&M. Students were specifically asked to recall if specific types of cases (resident at fault, medical error, non-therapeutic operation, pre- or post-operative mismanagement, multiple levels of error, and preventable or non-preventable error) were discussed. They were also asked to recall if tenets of surgical care (patient safety, quality improvement, root cause analysis, never events, time out/critical pause, complication vs preventable error) were discussed during M&M. Responses were tabulated and descriptive statistics were performed to summarize the data. Univariate analysis with a Chi-squared test, or Fisher’s Exact test when appropriate, was performed for association.Results:A total of 251 students were surveyed over four clinical sites. Of these students, 236 (94.0%) felt they understood the purpose of M&M, and 233 (88.8%) students felt they understood quality improvement in medicine and surgery. However, only 136 (54.2%) students reported M&M as a valuable learning experience. Discussion of the following was associated with a positive experience: examples of patient safety (93.4% vs 84.3%, p=0.02), preventable (91.2% vs 75.4%, p<0.01) or non-preventable (76.5% vs 55.3%, p<0.01) errors, quality improvement (95.6% vs 71.9%, p<0.01), and root cause analysis (59.6% vs 40.4%, p<0.01). Students were less likely to have a positive experience if they perceived M&M as a resident ‘grilling session’ (31.6% vs 51.4%, p<0.01). There was no association between interest in a surgical subspecialty and perceiving M&M as a positive learning experience (48.5% vs 50.5%, p = 0.29). Conclusion: Overall, only a very small majority of medical students view M&M as a positive learning experience. Introducing structured concepts focusing on quality improvement may serve as a viable strategy to enhance the learning experience. Prospective studies incorporating such a curriculum are warranted.

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Medical Student Perception of Morbidity and Mortality Conference