Surgical Evidence Blog Augments Resident Learning in M&M Conferences

February 2019

Long referred to as the golden hour of surgical education, the surgical morbidity and mortality (M&M) conference is a cornerstone activity for surgical trainees, and is mandated by the Accreditation Council for Graduate Medical Education as a required educational series for all institutions that have residency training programs. M&M conferences provide a forum for faculty and trainees to carefully explore the management details of particular cases involving morbidity or mortality so that insight can be gained into the circumstances of medical errors, complications, and unanticipated outcomes without judgement or repercussions. The motivation is that such examinations could improve the quality of response in future encounters with similar conditions.

However, the weekly, one-hour timeframe of the standard M&M conference is often unable to accommodate complete review of all of the components and related tangents of every topic introduced. In an effort to create an auxiliary source of amplification for these issues, Emory Surgery and the Woodruff Health Sciences Center Library have initiated the Surgical Focus blog to provide additional evidence-based information related to topics or questions raised in Emory Surgery’s M&M conferences.

"Studies have shown that only 40%-70% of clinical questions posed during M&M and other clinical conferences are actually addressed. We hope that Surgical Focus will help eliminate this educational leak for the benefit of our residents,” says Hannah Rutledge, PhD, MLIS, head of Clinical Informationist Services at the WHSC Library and the blog's curator in collaboration with PGY-2 resident Brendan Lovasik, MD.

After planning and development by Dr. Rutledge, Dr. Lovasik, Keith Delman, MD, program director of the general surgery residency, and Shishir Maithel, MD, faculty moderator of the M&M conferences, Surgical Focus launched in October 2018. The blog features each week's top topics of discussion and debate, paired with links to relevant studies, on-site summaries of those studies, and links to additional readings. Dr. Rutledge and Dr. Lovasik select the topics and associated studies and readings, and Dr. Rutledge posts and maintains the content and writes the summaries.

The blog also has category archives for compiling the topics, from general surgery clinical specialty areas to oncology, clinical trials, "great debates," perioperative care, and more.

"The role of the blog is not to provide absolute guidelines for a particular technique, course of treatment, or critical situation," says Dr. Lovasik. "Instead, we are presenting the primary areas of discourse and accompanying evidence to help residents and faculty provide the best evidence-based practices in their patient care."

Thus far, all signs point to the blog achieving its purpose. "A formal evaluation of the educational impact of the blog is still in early stages, but preliminary results have been encouraging," says Dr. Rutledge. "Monthly readership is increasing, and feedback from trainees and faculty has been exceedingly positive."