A Sisyphean Task for Residents: Preparing Literature Reviews About Adverse Events Presented at Morbidity and Mortality Conferences

Alexandros N Flaris; Christopher J Carnabatu; Alison Smith; Eric R Simms; John W Baker; Rebecca Schroll; Mary Killackey; Emad Kandil

doi:10.1016/j.jsurg.2022.07.010

A Sisyphean Task for Residents: Preparing Literature Reviews About Adverse Events Presented at Morbidity and Mortality Conferences

J Surg Educ. 2022 Nov-Dec;79(6):1500-1508. doi: 10.1016/j.jsurg.2022.07.010. Epub 2022 Jul 31.

Authors

Alexandros N Flaris¹, Christopher J Carnabatu², Alison Smith², Eric R Simms³, John W Baker², Rebecca Schroll², Mary Killackey², Emad Kandil²

Affiliations

¹ General Surgery Department, Tulane University, New Orleans, Louisiana. Electronic address: aflaris@tulane.edu.
² General Surgery Department, Tulane University, New Orleans, Louisiana.
³ Department of Surgery, Harbor-UCLA Medical Center, Torrance, California.

PMID: 35922256
DOI: 10.1016/j.jsurg.2022.07.010

Abstract

Objective: Surgery Morbidity and Mortality (M&M) presentations include a thorough literature review. This requires a significant amount of time expenditure frequently incompatible with the current surgical resident work hours. Additionally, literature reviews can be redundant for commonly encountered adverse events. The goal of this study was to explore (a) how surgery residents perform literature reviews, and (b) how repetitive presented adverse events are.

Design: A survey was sent out during the academic year 2019-2020. The Morbidity and Mortality repository for that academic year was indexed, and the proportion of adverse events having occurred more than once calculated. The amount of time spent on literature reviews, proportion of repetitive adverse events as well as degree of thoroughness of reviews was evaluated on a 1 to 5 Likert scale.

Setting: Tulane University General Surgery program, New Orleans, LA, USA.

Participants: All clinically active residents.

Results: All residents, filled out the survey. Seventeen out of 29 (58.6%) residents reported dedicating approximately one hour performing literature reviews. Median studying time was 1 hour (interquartile range: 1-1.5 hours). Seventeen out of 29 (58.6%) residents employed 2 resources. The most common combination of resources was PubMed and Google (11/29, 37.9%). Most residents (21/29, 72.4%) believed that their thoroughness was at most average (≤3/5 on a Likert scale) and 27/29 (93.1%) believed that their literature review could have been more thorough. More than half of the adverse events presented were found to be redundant during that academic year.

Conclusions: Time spent reviewing the literature does not allow for a thorough review, and a significant portion of adverse events presented are redundant. A central repository for literature reviews of adverse events would improve the quality of reviews and avoid duplicating efforts.

Keywords: Complication; Redundancy; Repetitiveness; Surgical education; Trainee.

MeSH terms

Humans
Internship and Residency*
Morbidity
Time and Motion Studies