Paul J. Schenarts, Michael P. Meara and Brett H. Waibel
The M&M conference is a corner stone of surgical education. Frequently, this conference requires the resident to effectively put forth an argument why the supervising attending made particular decisions. As such a resident’s performance is based not only on factual knowledge but also on his or her understanding of the basic principles of argumentation, persuasion and the art of oral argument. This manuscript provides a basic overview of these principles. The morbidity and mortality conference (M&M) is a cornerstone of surgical education. Probing of the depths of the resident’s fund of knowledge, identifying areas of misunderstanding and improving critical reasoning skills are unquestionably fundamental to the development of a surgeon. Accountability is an essential surgical value and constitutes another important aspect of this conference. While at times the focus of an M&M presentation is on holding the Resident is accountable for his or her individual actions. More frequently, the M&M conference resembles a court room in which the resident is put in the position of representing a faculty member and articulating the rationale for the decisions made by that faculty member. In this process, the resident acts similar to a lawyer, who is charged with persuading judges (other faculty members) that the decisions of the supervising faculty were appropriate. While the resident may have executed the decisions, the resident’s ability to defend these decisions has a direct impact on the resident’s professional reputation and written evaluations. To carry this analogy further, the M&M conference may also include the presence of opposing counsel, in the form of adversarial faculty; who may be in a direct competitive relationship with the faculty member whom the resident is representing. Given the premise that the M&M conference is reflective of a court of law, there may be valuable check surgical residents could learn from the legal scholars. Recently, Associate Justice of the Supreme Court of the United States, Antonin Scalia and legal scholar Bryan A. Garner, have published a useful guide on how effective advocates persuade courts to decide cases in favor of their clients . In particular, the sections on the principles of persuasion, argumentation, and the art of oral argument offer useful advice which could be translated for surgical residents as they prepare to present at the M&M conference. The principles outlined in their book serve as the foundation of this manuscript and have been adapted to meet the needs of surgical residents. The recommendations that follow are not based on objective scientific data. This logical framework, however, provides a useful guide for residents who wish to improve the quality of their M&M presentations.