SBAR M&amp;M: a feasible, reliable, and valid tool to assess the quality of, surgical morbidity and mortality conference presentations

Mitchell, Erica L.; Lee, Dae Y.; Arora, Sonal; Kwong, Karen L.; Liem, Timothy K.; Landry, Gregory L.; Moneta, Gregory L.; Sevdalis, Nick

doi:10.1016/j.amjsurg.2011.07.008

Cited by 47 publications

(71 citation statements)

References 7 publications

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“…Residents are left in these moments to side for themselves on the application of evidence to variations or the primacy of surgeon individuality. Research on morbidity and mortality rounds shows that more explicit attention to practice variations and evidence is expected of surgeons and residents, 46,47 as in other specialties, 48 outside the operating room. Once inside the confines of the operating room, however, our findings suggest that residents learn to remain attuned to the role of evidence in procedural learning but only insofar as that attunement does not prevent them from enacting surgical culture's basic assumptions of autonomy and individuality.…”

Section: Navigating Those Normsmentioning

confidence: 99%

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Apramian¹,

Cristancho²,

Watling³

et al. 2016

Journal of Surgical Education

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OBJECTIVE-Clinical research increasingly acknowledges the existence of significant procedural variation in surgical practice. This study explored surgeons' perspectives regarding the influence of intersurgeon procedural variation on the teaching and learning of surgical residents.DESIGN AND SETTING-This qualitative study used a grounded theory-based analysis of observational and interview data. Observational data were collected in 3 tertiary care teaching hospitals in Ontario, Canada. Semistructured interviews explored potential procedural variations arising during the observations and prompts from an iteratively refined guide. Ongoing data analysis refined the theoretical framework and informed data collection strategies, as prescribed by the iterative nature of grounded theory research. RESULTS-Surgeons endorsed the use of intersurgeon procedural variations to teach residents about adapting to the complexity of surgical practice and the norms of surgical culture. Surgeons suggested that residents' efforts to identify thresholds of principle and preference are crucial to professional development. Principles that emerged from the study included the following: (1) knowing what comes next, (2) choosing the right plane, (3) handling tissue appropriately, (4) recognizing the abnormal, and (5) making safe progress. Surgeons suggested that learning to follow these principles while maintaining key aspects of surgical culture, like autonomy and individuality, are important social processes in surgical education. PARTICIPANTS-OurCONCLUSIONS-Acknowledging intersurgeon variation has important implications for curriculum development and workplace-based assessment in surgical education. Adapting to intersurgeon procedural variations may foster versatility in surgical residents. However, the existence of procedural variations and their active use in surgeons' teaching raises questions about the lack of attention to this form of complexity in current workplace-based assessment strategies. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptFailure to recognize the role of such variations may threaten the implementation of competencybased medical education in surgery.

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Section: Navigating Those Normsmentioning

confidence: 99%

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Apramian¹,

Cristancho²,

Watling³

et al. 2016

Journal of Surgical Education

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“…An assessment tool for trainees based on the SBAR format has been developed for evaluation of the quality of presentation at surgical rounds, which provides information on the quality of presentations and can be used to provide objective feedback to presenters. 48 Our study provides evidence that the quality of patient handoff/communication between multidisciplinary transport team members improved after the introduction of the SBAR report to physician tool. While our study was able to demonstrate an improvement in the overall quality of information shared, we did not assess the impact this had on clinical care or outcomes such as neonatal morbidity and mortality.…”

Section: Discussionmentioning

confidence: 65%

Evaluation of a Modified SBAR Report to Physician Tool to Standardize Communication on Neonatal Transport

et al. 2020

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Objective SBAR (situation, background, assessment and recommendation) is a structured format for the effective communication of critically relevant information. This tool was developed as a generic template to provide structure to the communication of clinical information between health care providers. Neonatal transport often presents clinically stressful circumstances where concise and accurate information is required to be shared clearly between multidisciplinary health care providers. A modified SBAR communication tool was designed to facilitate structured communication between nonphysician bedside care providers operating from remote sites and physicians providing decision-making support at receiving care facilities. Prospective interventional study was designed to evaluate the reliability of a “SBAR report to physician tool” in sharing clinically relevant information between multidisciplinary care providers on neonatal transport. Study Design The study was conducted between 2011 and 2014 by a dedicated neonatal transport service based at McMaster Children's Hospital which provides care for approximately 500 infants in Southern Ontario annually. In the preintervention phase, 50 calls were randomly selected for the evaluation and 115 consecutively recorded transport calls following adoption of the reporting tool. The quality of calls prior to and after the intervention was assessed by reviewers independently. Inter-rater agreement was also assessed for both periods. Results Inter-rater agreement between raters was moderate to perfect in most components of the SBAR “report to the physician tool” except for the assessment component, which showed fair agreement during both preintervention and postintervention periods. There was an improvement in global score (primary outcome) with a mean difference of 0.95 (95% confidence interval [CI]: 0.77–1.14; p < 0.001) and in cumulative score with a mean difference of 8.55 (95% CI: 7.26–9.84; p < 0.001) in postintervention period. Conclusion The use of the SBAR report to physician tool improved the quality of clinical information shared between nonphysician members of the neonatal transport team and neonatal transport physicians. Key Points

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“…Other researchers have published tools to standardise the format of presentation and hence improve the educational experience during M&M rounds 14 15. These tools generally consist of modified situational awareness aids and provide a rubric, which guides the speaker in their analysis of the case.…”

Section: Discussionmentioning

confidence: 99%

Teaching M&M rounds skills: enhancing and assessing patient safety competencies using the Ottawa M&M model

Mondoux

Frank

Kwok

et al. 2016

Postgraduate Medical Journal

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SBAR M&M: a feasible, reliable, and valid tool to assess the quality of, surgical morbidity and mortality conference presentations

Cited by 47 publications

References 7 publications

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

“They Have to Adapt to Learn”: Surgeons’ Perspectives on the Role of Procedural Variation in Surgical Education

Evaluation of a Modified SBAR Report to Physician Tool to Standardize Communication on Neonatal Transport

Teaching M&M rounds skills: enhancing and assessing patient safety competencies using the Ottawa M&M model

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