title: Teaching M&M rounds skills: enhancing and assessing patient safety competencies using the Ottawa M&M model.
abstract: BACKGROUND
  Postgraduate medical education bodies and national patient safety institutes recommend that trainees develop patient safety competencies such as those for Morbidity and Mortality (M&M) rounds, yet there exists no model for their educational delivery.
  
  
  OBJECTIVE
  We studied the effect of a single educational intervention on emergency medicine residents' aptitudes in selecting and analysing M&M rounds cases.
  
  
  METHODS
  In this before-and-after study, participants attended an 1 h educational session based on the previously described Ottawa Morbidity and Mortality Model (OM3). Residents were asked to submit a case suitable for M&M rounds both preintervention and postintervention. A novel M&M rounds case critique tool was developed based on OM3 and used to assign a numerical score to each submitted case. Our primary outcome was an increase in mean scores between phases using the case critique tool. An a priori score increase of 1 was defined as educationally significant. Data were analysed using a paired Student's t test.
  
  
  RESULTS
  A total of 19 residents were recruited for our pre-intervention and 15 residents for the post-intervention analysis. Mean M&M rounds case critique scores increased from 5.53 to 8.67 (p<0.01) between phases. Residents reported higher comfort with structured case selection and analysis, with an increase in five-point Likert scale means of 2.32 and 3.69 (p<0.01).
  
  
  CONCLUSIONS
  We found that residents were more effective at M&M rounds case selection and analysis after our focused 1 h educational intervention. Training programmes should consider an M&M rounds training model to ensure future physicians have these skills for 21st-century practice.
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: Shawn E
authors.initials: SE
authors.lastname: Mondoux
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: Jason R
authors.initials: JR
authors.lastname: Frank
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: Edmund S H
authors.initials: ESH
authors.lastname: Kwok
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: A Adam
authors.initials: AA
authors.lastname: Cwinn
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: A Curtis
authors.initials: AC
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, University of Ottawa, Ontario, Ontario, Canada.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Calder
keywords: ACCIDENT & EMERGENCY MEDICINE; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; MEDICAL EDUCATION & TRAINING