{"id":{"repo_id":"uic","oai_identifier":"oai:figshare.com:article/31451419"},"canonical_url":"https://search.dev.ndltd.org/etd/uic/oai:figshare.com:article/31451419","repository":{"repo_id":"uic","name":"University of Illinois - Chicago","base_url":"https://api.figshare.com/v2/oai"},"display":{"title":"Program Director Description of Morbidity and Mortality Conference: A Grounded Theory Interview Study","abstract":"ABSTRACT Background: M&MC has a variable effect on participants based on level of experience and role. In surgical disciplines M&MC is frequent, required and reflects a program’s culture. Context is created by interactions. Four different populations participate: surgical attending faculty, surgical residents, medical students, and program administrators including the residency program director (PD). A program’s PD offers a point of view centered on their responsibility for resident development. The goal of this project is a rich description of the current state of M&MC in US surgical education from a program director’s point of view. Focused Research Question: How do surgical residency leaders understand M&MC’s current context, social conditions, and potential for developing professional accountability in modern trainees? Design/Methods: This research employed a constructivist paradigm guided by the work of Charmaz (2014). Purposive sampling identified fifty program directors (PDs) diverse in location, structure, and years of experience in the role. Five specialties in North American universities were included: general surgery, obstetrics and gynecology, orthopaedics, otolaryngology, and neurosurgery. PDs engaged in interviews that emphasized their experiences in M&MC. Interviews were transcribed verbatim and coded by the PI. Theoretical sampling was used to organize the focused codes and their subcodes into four themes: changing perspectives and the evolution of M&MC over time, optimizing M&MC in the current climate, specific content of the meeting and peer-based assessment, and its role in identify formation. The overall content fell under human relationships within M&MC consistent with program director (PD) role with respect to the conference. The primary investigator built a grounded theory through iterative analysis. Results: 44 agreed to participate (88%). Study completion was 100%. Interview recordings ranged from 58 to 84 minutes (average 71 minutes). There was variation in residency size, proportion of acute versus elective cases, and degree of sub-specialization. The year of graduation from residency and the length of time in the role for the program directors interviewed was consistent across specialties and represented all levels of both surgeon and educator experience. Coding revealed seven major themes: •It is clear M&MC is evolving away from the traditional shame and blame culture and that program directors (PDs) are invested in that process. •It is clear the structure of both the conference and the departmental system around it has evolved in response to external needs and threats. •Through the eyes of PDs, it is clear social conditions highlight the potential for developing accountability within the meeting itself. •The current shift to hybrid or virtual format separates the community if not done well. PDs are attentive to this threat. •PDs do not report consistent combined learner and faculty involvement in case selection, presentation or analysis. There are limits to current case reporting standards. •PDs reflect a sense of responsibility to contribute to collective learning but a sense of isolation in that effort. •Interviews demonstrate no significant evidence for conference-related faculty development despite its recognized importance. Conclusions: This study revealed that exploring the tensions around, evolution of, and communal value intrinsic to M&MC are key to understanding its utility in today’s surgical education. The author theorizes that faculty development is important to optimizing the role of M&MC in the professional development of a surgeon.","abstract_html":"ABSTRACT Background: M&MC has a variable effect on participants based on level of experience and role. In surgical disciplines M&MC is frequent, required and reflects a program’s culture. Context is created by interactions. Four different populations participate: surgical attending faculty, surgical residents, medical students, and program administrators including the residency program director (PD). A program’s PD offers a point of view centered on their responsibility for resident development. The goal of this project is a rich description of the current state of M&MC in US surgical education from a program director’s point of view. Focused Research Question: How do surgical residency leaders understand M&MC’s current context, social conditions, and potential for developing professional accountability in modern trainees? Design/Methods: This research employed a constructivist paradigm guided by the work of Charmaz (2014). Purposive sampling identified fifty program directors (PDs) diverse in location, structure, and years of experience in the role. Five specialties in North American universities were included: general surgery, obstetrics and gynecology, orthopaedics, otolaryngology, and neurosurgery. PDs engaged in interviews that emphasized their experiences in M&MC. Interviews were transcribed verbatim and coded by the PI. Theoretical sampling was used to organize the focused codes and their subcodes into four themes: changing perspectives and the evolution of M&MC over time, optimizing M&MC in the current climate, specific content of the meeting and peer-based assessment, and its role in identify formation. The overall content fell under human relationships within M&MC consistent with program director (PD) role with respect to the conference. The primary investigator built a grounded theory through iterative analysis. Results: 44 agreed to participate (88%). Study completion was 100%. Interview recordings ranged from 58 to 84 minutes (average 71 minutes). There was variation in residency size, proportion of acute versus elective cases, and degree of sub-specialization. The year of graduation from residency and the length of time in the role for the program directors interviewed was consistent across specialties and represented all levels of both surgeon and educator experience. Coding revealed seven major themes: •It is clear M&MC is evolving away from the traditional shame and blame culture and that program directors (PDs) are invested in that process. •It is clear the structure of both the conference and the departmental system around it has evolved in response to external needs and threats. •Through the eyes of PDs, it is clear social conditions highlight the potential for developing accountability within the meeting itself. •The current shift to hybrid or virtual format separates the community if not done well. PDs are attentive to this threat. •PDs do not report consistent combined learner and faculty involvement in case selection, presentation or analysis. There are limits to current case reporting standards. •PDs reflect a sense of responsibility to contribute to collective learning but a sense of isolation in that effort. •Interviews demonstrate no significant evidence for conference-related faculty development despite its recognized importance. Conclusions: This study revealed that exploring the tensions around, evolution of, and communal value intrinsic to M&MC are key to understanding its utility in today’s surgical education. The author theorizes that faculty development is important to optimizing the role of M&MC in the professional development of a surgeon.","abstract_has_math":false,"creators":["S. Elizabeth Ames (23291656)"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-12-01T00:00:00Z","date_published":"2025-12-01T00:00:00Z","updated_at":"2026-07-27T21:34:25Z","subjects":["surgical program directors"],"languages":[],"rights":["In Copyright"],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://doi.org/10.25417/uic.31451419.v1","outbound_label":"DOI","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:creator","label":"Author","values":["S. Elizabeth Ames (23291656)"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date","label":"Dc Date","values":["2025-12-01T00:00:00Z"]},{"key":"dc:relation","label":"Dc Relation","values":["https://figshare.com/articles/thesis/Program_Director_Description_of_Morbidity_and_Mortality_Conference_A_Grounded_Theory_Interview_Study/31451419"]},{"key":"dc:type","label":"Dc Type","values":["Text","Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["surgical program directors"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["In Copyright"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["10.25417/uic.31451419.v1"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["ABSTRACT Background: M&MC has a variable effect on participants based on level of experience and role. In surgical disciplines M&MC is frequent, required and reflects a program’s culture. Context is created by interactions. Four different populations participate: surgical attending faculty, surgical residents, medical students, and program administrators including the residency program director (PD). A program’s PD offers a point of view centered on their responsibility for resident development. The goal of this project is a rich description of the current state of M&MC in US surgical education from a program director’s point of view. Focused Research Question: How do surgical residency leaders understand M&MC’s current context, social conditions, and potential for developing professional accountability in modern trainees? Design/Methods: This research employed a constructivist paradigm guided by the work of Charmaz (2014). Purposive sampling identified fifty program directors (PDs) diverse in location, structure, and years of experience in the role. Five specialties in North American universities were included: general surgery, obstetrics and gynecology, orthopaedics, otolaryngology, and neurosurgery. PDs engaged in interviews that emphasized their experiences in M&MC. Interviews were transcribed verbatim and coded by the PI. Theoretical sampling was used to organize the focused codes and their subcodes into four themes: changing perspectives and the evolution of M&MC over time, optimizing M&MC in the current climate, specific content of the meeting and peer-based assessment, and its role in identify formation. The overall content fell under human relationships within M&MC consistent with program director (PD) role with respect to the conference. The primary investigator built a grounded theory through iterative analysis. Results: 44 agreed to participate (88%). Study completion was 100%. Interview recordings ranged from 58 to 84 minutes (average 71 minutes). There was variation in residency size, proportion of acute versus elective cases, and degree of sub-specialization. The year of graduation from residency and the length of time in the role for the program directors interviewed was consistent across specialties and represented all levels of both surgeon and educator experience. Coding revealed seven major themes: •It is clear M&MC is evolving away from the traditional shame and blame culture and that program directors (PDs) are invested in that process. •It is clear the structure of both the conference and the departmental system around it has evolved in response to external needs and threats. •Through the eyes of PDs, it is clear social conditions highlight the potential for developing accountability within the meeting itself. •The current shift to hybrid or virtual format separates the community if not done well. PDs are attentive to this threat. •PDs do not report consistent combined learner and faculty involvement in case selection, presentation or analysis. There are limits to current case reporting standards. •PDs reflect a sense of responsibility to contribute to collective learning but a sense of isolation in that effort. •Interviews demonstrate no significant evidence for conference-related faculty development despite its recognized importance. Conclusions: This study revealed that exploring the tensions around, evolution of, and communal value intrinsic to M&MC are key to understanding its utility in today’s surgical education. The author theorizes that faculty development is important to optimizing the role of M&MC in the professional development of a surgeon."]},{"key":"dc:title","label":"Title","values":["Program Director Description of Morbidity and Mortality Conference: A Grounded Theory Interview Study"]}]}],"canonical_facts":{"dc:creator":["S. Elizabeth Ames (23291656)"],"dc:date":["2025-12-01T00:00:00Z"],"dc:description":["ABSTRACT Background: M&MC has a variable effect on participants based on level of experience and role. In surgical disciplines M&MC is frequent, required and reflects a program’s culture. Context is created by interactions. Four different populations participate: surgical attending faculty, surgical residents, medical students, and program administrators including the residency program director (PD). A program’s PD offers a point of view centered on their responsibility for resident development. The goal of this project is a rich description of the current state of M&MC in US surgical education from a program director’s point of view. Focused Research Question: How do surgical residency leaders understand M&MC’s current context, social conditions, and potential for developing professional accountability in modern trainees? Design/Methods: This research employed a constructivist paradigm guided by the work of Charmaz (2014). Purposive sampling identified fifty program directors (PDs) diverse in location, structure, and years of experience in the role. Five specialties in North American universities were included: general surgery, obstetrics and gynecology, orthopaedics, otolaryngology, and neurosurgery. PDs engaged in interviews that emphasized their experiences in M&MC. Interviews were transcribed verbatim and coded by the PI. Theoretical sampling was used to organize the focused codes and their subcodes into four themes: changing perspectives and the evolution of M&MC over time, optimizing M&MC in the current climate, specific content of the meeting and peer-based assessment, and its role in identify formation. The overall content fell under human relationships within M&MC consistent with program director (PD) role with respect to the conference. The primary investigator built a grounded theory through iterative analysis. Results: 44 agreed to participate (88%). Study completion was 100%. Interview recordings ranged from 58 to 84 minutes (average 71 minutes). There was variation in residency size, proportion of acute versus elective cases, and degree of sub-specialization. The year of graduation from residency and the length of time in the role for the program directors interviewed was consistent across specialties and represented all levels of both surgeon and educator experience. Coding revealed seven major themes: •It is clear M&MC is evolving away from the traditional shame and blame culture and that program directors (PDs) are invested in that process. •It is clear the structure of both the conference and the departmental system around it has evolved in response to external needs and threats. •Through the eyes of PDs, it is clear social conditions highlight the potential for developing accountability within the meeting itself. •The current shift to hybrid or virtual format separates the community if not done well. PDs are attentive to this threat. •PDs do not report consistent combined learner and faculty involvement in case selection, presentation or analysis. There are limits to current case reporting standards. •PDs reflect a sense of responsibility to contribute to collective learning but a sense of isolation in that effort. •Interviews demonstrate no significant evidence for conference-related faculty development despite its recognized importance. Conclusions: This study revealed that exploring the tensions around, evolution of, and communal value intrinsic to M&MC are key to understanding its utility in today’s surgical education. The author theorizes that faculty development is important to optimizing the role of M&MC in the professional development of a surgeon."],"dc:identifier":["10.25417/uic.31451419.v1"],"dc:relation":["https://figshare.com/articles/thesis/Program_Director_Description_of_Morbidity_and_Mortality_Conference_A_Grounded_Theory_Interview_Study/31451419"],"dc:rights":["In Copyright"],"dc:subject":["surgical program directors"],"dc:title":["Program Director Description of Morbidity and Mortality Conference: A Grounded Theory Interview Study"],"dc:type":["Text","Thesis"]},"updated_at":"2026-07-27T21:34:25Z"}