QUALITY IMPROVEMENT
Quantifying recall bias in surgical safety
Published on
February 1, 2019
Canadian Journal of Surgery
Overview
Recent investments in healthcare quality improvement have largely overlooked the need for modernizing surgical methods, particularly in the context of morbidity and mortality conferences (MMCs), which have remained static for over a century. This study aimed to evaluate the recall bias of surgical teams regarding routine cases by collecting immediate postoperative questionnaires from one surgeon, one fellow, and eleven trainees after 25 surgeries. A follow-up questionnaire was administered 7 to 9 days later to assess their recollections.
The results revealed a significant discrepancy in participants' memories, with all team members inaccurately recalling critical details, including the occurrence of adverse events. Despite expressing feelings of mental preparedness and concentration during the surgeries, the surgical team misclassified operations with and without complications in nearly every instance. These findings underscore the prevalence of recall bias in surgical safety events, highlighting its potential to undermine the accuracy of data discussed at MMCs and indicating a pressing need for updated methods in surgical quality improvement.
Results
After 1 week, members of the surgical team were universally inaccurate in their recollection of even major details from the operating room. Although most participants felt mentally prepared and perceived no issues with concentration during the case, all participants misclassified operations as having been performed with or without adverse events in almost every included case.
