Table 1 Survey Design. An optional 19th item was also included, inviting the participant to leave an email address solely to avoid receiving reminder emails

1

How often does your surgical department hold Morbidity & Mortality (M&M) meetings?

≧ 2x per month / Every month / Every 2 months / Every 3 months / Every 4–6 months / 2x per year / 1x per year / < 1x per year / Never / I don’t know / Other ____________

2

At the time of completing this survey, are you aware of the inclusion criteria for case discussion at your departmental M&M meeting?

Yes / No (Question logic: Moves to Q4 if answers No)

3

What are these inclusion criteria? (Open question)

4

Does your M&M meeting include data on outpatient events? This refers to morbidity/mortality that occurs or is identified in the outpatient setting.

Yes / No / I don’t know

5

Are these M&M meetings within ‘protected time’ (i.e. with no concurrent scheduled elective activities)?

Yes / No / I don’t know

6

Please estimate the proportion of scheduled M&M meetings that you have attended in the last 12 months.

None / Rarely / Less than a quarter / Less than half / Around half / More than half / Almost all / All

7

Who routinely attends your department’s M&M meetings? Select all that apply.

Medical Students / FY1 Doctors / SHOs (including FY2) / Registrars / Other clinical specialties / Nursing staff (at least one) / Managerial staff (at least one) / Other (please state)

8

In your department’s M&M meetings, is there routinely a clearly-delegated chair person?

Yes - consultant surgeon / Yes – non-consultant grade / No / I don’t know

9

How judgmental do you find the environment within the M&M meeting? (1 = very judgmental, 10 = non-judgmental)

10

How would you rate your own willingness or ability to talk openly about your complications/mortalities during the M&M meeting? (1 = unwilling/unable, 10 = willing/able)

11

Please rate your fear of criticism from your peers during M&M meetings (1 = very fearful, 10 = fearless)

12

Please rate your fear of legal or other negative repercussions resulting from completely open discussion of your complications/mortalities (1 = very fearful, 10 = fearless)

13

Are there any other factors that hinder your openness in discussion of your complications during an M&M meeting? (Open question)

14

How conducive do you feel your M&M meetings are for learning? (1 = not at all, 10 = highly conducive)

15

How conducive do you feel your M&M meetings are for service improvement? (1 = not at all, 10 = highly conducive)

16

To what extent do you feel individuals’ performance (e.g. decision-making) receives the focus of M&M discussions? (1 = not at all, 10 = exclusively about individuals’ performance)

17

To what extent do you feel systems and processes (e.g. equipment issues, staffing levels, pathway deficiencies) receive the focus of M&M discussions? (1 = not at all, 10 = exclusively about systems and processes)

18

How are the discussions/outcomes disseminated following an M&M meeting?

I don’t know / M&M meeting records are not available / They are given or sent to me in paper format / They are emailed to me / They are accessible but I do not know how to obtain them / They are accessible and I know how to obtain them / Other (please state)