Morbidity and Mortality Conference – a clinical problem solving opportunity


Category : Medical Rants

For over 5 years, at our Huntsville campus, we have inserted M&M into our Grand Rounds schedule. We started our series for the Family Medicine senior residents. Once the Internal Medicine program started and had senior residents we expanded the number of M&M slots so that we now have 12 Family Medicine weeks and 8 Internal Medicine weeks.

We believe our format is a bit different. The resident presents the information in chunks (one slide at a time). The moderator then challenges the remaining residents to speculate on what is wrong with the patient, what further information they would want, what orders are appropriate at that time.

Over the hour, the story unfolds, laying out the decision making and what errors may have occurred.

We introduce this series every year with several cautions. The retrospectoscope always trumps our other scopes. We all make mistakes, and the purpose of our conference is not to skewer those who made mistakes, but rather to learn how to avoid such mistakes.

At dinner last night with some 3rd year medical students, they strongly endorsed this conference as having special value to them. They want to understand thought processes, and the conference, as we run it, focuses on decision making opportunities.

Melding a clinical problem solving approach with M&M seems to make the conference more educational and not punitive. We stress often that during the “Fog of War” one cannot easily make such decisions unless one has prepared carefully though vehicles like our M&M.

The students last night loved the mystery solving as the story unfolds. They feel like participants rather than observers. Methinks the conference is achieving its goals.

Comments (1)

I completely agree with the M&M conferences being a learning experience! No one is perfect and as humans we all make mistakes as you said. However, the M&M give the great gift of knowledge as to remind all of what could be improved and expand on medical mysteries. It’s good to have such curious and ambitious residents that still have their appeal to everything about the medical field compared to tiresome residents that seem to be fed up. All in all, I thoroughly enjoyed this blog posting pertaining to the medical field!

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