Staff memo gets M&M message to wider audience
Below is a typical M&M Monday Memo from Cedars Sinai Medical Center in Los Angeles. It serves two purposes. It is the moderator’s summary about the previous week’s conference. It is narrative and addresses issues raised at the conference.
It also is used as a vehicle for extending the discussions at the conference through the use of Q/A e-mails:
M&M Monday Memo for Dec. 3, 2001 Comments, Observations and Insights from the Surgical Morbidity and Mortality Conference at the Cedars-Sinai Medical CenterAfter Thursday’s conference, my mail covered the spectrum of the surgical literature from the bound, hallowed pages of The Journal of the American College of Surgeons to the folded tabloid pages of General Surgery News.
Both publications had central articles on many issues surrounding our weekly conference. One, by Dr. William Silen writing in the Journal of the American College of Surgeons, is a scathing assessment of current surgical education, leading to the conclusion that "current trainees are the recipients of an extremely bad educational experience."
The other was by Dr. Barry McKernan writing in General Surgery News. Dr. McKernan calls for a "new" educational model that would allow questioning, develop independent thinking, develop an ethic of cooperation, remain flexible, welcome change and focus on relevancy to practice.
Our conference allows questioning, develops independent thinking among our residents, develops a spirit of attending/resident cooperation, is flexible and focuses on issues relevant to practice. I will invite both Dr. Silen and Dr. McKernan to one of our meetings, because I think we have this "new" educational model of Dr. McKernan that can reverse the disheartening trends outlined by Dr. Silen.
Now to the e-mails. I am sorry that I cannot answer each e-mail received. An attending surgeon writes: "The presentation on myocardial dysfunction was a bit peripheral to the case. Do we have to discuss myocardial depression after a GSW as a surgical complication?"
The M&M moderator responds: The discussion of this case was among the most enlightening we have had at our conference. Keep in mind that our profession is grounded in basic physiology. Although I questioned the categorization of this case, there was no question that the issue was worth discussing. The resident had spent quite a bit of time in preparing what most attendees thought was a good review of this emerging concept.
An attending surgeon wrote: "I did not understand the point made about approaching the duodenum laterally in the fistula case."
The M&M moderator responds: The surgeon who made this comment is an "anatomic strategist." If the anterior approach to the abdomen was difficult, the speaker recommended a retroperitoneal approach, much like the retro-peritoneal approach to an abdominal aortic aneurysm.
An attending surgeon wrote: "Are the residents aware of the department of medical photography? The description of the abdomen in the fistula case, while I am sure it was accurate, was tough to envision."
The M&M moderator responds: Photodocumentation would have made the case presentation more understandable. The resident staff will be reminded of the availability of this service.
Reminder: The second M&M Matrix examination will be given on Thursday, Dec. 13 at 0715 hrs. All M&M attendees are invited. n
EMTALA audio conference
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