TOTB-07: DISCUSSING DEATH: EXAMINING THE ETHICAL AND EMOTIONAL ASPECTS OF ADVERSE EVENTS
Rebecca Lynn Williams, MD, PhD; University of New Mexico Hospital

What problem in education is addressed by this work?:
Adverse patient outcomes can have significant psychological and emotional effects on surgeons, including depression, anxiety, and loss of confidence. Despite this, formal discussions of adverse outcomes are largely confined to weekly Morbidity and Mortality conferences that focus on the technical, cognitive, and systems factors leading to these events. As surgery is confronted with an epidemic of burnout in trainees and senior providers alike, Morbidity and Mortality conferences should be viewed as a vital resource for training surgeons to better cope with setbacks and loss.

Describe the intervention:
Our institution has integrated two unique interventions into our standard Morbidity and Mortality conference to expand the dialogue around adverse patients outcomes and deaths. The first intervention is a quarterly series during which cases with complex ethical considerations are presented and discussed. The second intervention is an annual patient memorial, during which surgeons and trainees of all levels are invited to share the emotional impact the loss of a patient has had on them in a supportive, nonjudgmental environment.

Describe how this intervention could be applied at other institutions. Please specifically comment on identified barriers that could exist and how they could be overcome:
Implementation of these interventions require little preparation beyond what is already generally required for standard weekly Morbidity and Mortality conferences. Barriers to implementation predominantly relate to discomfort with vulnerability and disclosure of emotions. Inclusion of faculty and other members of the institution with training in ethics, palliative care, and chaplaincy can provide valuable resources and support.