The premise sounds a little iffy: combining committee dynamics with game-show
technology in a dense, daylong workshop. But the five-star faculty at
the CAP ’05 event next month is betting it will deliver a blueprint for
clear and complete pathology reports.
The program will have a traditional start. M. Elizabeth H. Hammond, MD,
program director, will open the session on Sept. 13 in Chicago by describing
reporting habits associated with malpractice risk, drawing on data from
The Doctors' Company and the CAP Q-Probes and Q-Tracks programs. Later,
she'll present good and bad reports and ask the audience to judge each
for effectiveness, utility, and clarity. Ronald Sirota, MD, will focus
on how reports can cause clinical error and what can be done about it;
Thomas McGowan, MD, MBA, on cancer reports and formatting; Richard Zarbo,
MD, DMD, on the correct way to amend and add to a completed report; and
Robert Rainer, MD, on CAP efforts to improve tools for interfacing reports
and information systems.
"People have strong views about how their reports should be created and
they don't like to believe it's important to standardize those reports,"
Dr. Hammond says. "But we're going to present evidence that standardizing
those reports is the best way to get high-quality, good information for
patients and doctors, protection from malpractice risk, and documentation
of what was done so they can get paid."
What will make this program different is the use of audience participation
via "Who Wants To Be a Millionaire" technology. Audience members will
be asked to respond to multiple-choice statements about each speaker's
session—for example, whether reports have affected billing results,
whether they've been used as evidence in malpractice cases, whether some
or all of their reports are synoptic, and more. Wireless personal response
systems given to each attendee will capture the group's feedback on an
overhead screen. As discussion evolves, participants will collaborate,
construct new questions, and vote again. The brainstorming should be in
near-real time, and at the end of the day, the College should know precisely
what its members are seeking in pathology reporting support.
The outcome will become marching orders for a CAP Council on Scientific
Affairs task force charged with executing the results of the workshop.
"I intend to come up with a PowerPoint and put it on the Web site after
the meeting is over," says Dr. Hammond, chair of the CAP's Education Committee.
"They're going to have to live with what they say, but so am I, and so
is the CAP—and that's good. If they know what they want and they
tell us, we're going to do it."
Members of the planning committee for the workshop are the chairs of
several committees within the College, as well as House of Delegates speaker
Mary Nielsen, MD, who was one of three authors of a resolution adopted
last year by the House of Delegates that was the genesis of this activity.
The resolution, she says, reflected worries about pathologist vulnerability
when reports are inconsistent, unclear, or incomplete.
"Our reports are out there, and they're what most people see of us,"
Dr. Nielsen says. "Some people have criticized reports and said they could
be clearer and we could do much better. We all struggle with how to say
something that is difficult to word. We felt the CAP could tackle that."
CAP president Mary E. Kass, MD, expects the workshop to be among the
"standout programs" at this year's annual meeting. "One of the first surgical
pathologists I studied under told me that the more words you use, the
less certain you are of the diagnosis," she says. "When I know what it
is, it doesn't take many words to describe it.
"We've got to be direct and to the point. It's very, very important
that we get this right. We have to take a leadership role. That's why
it's a whole-day course."
The course planners decided to make use of the wireless personal response
systems because they believe the anonymity will encourage participants
to be candid. "It's exciting as a participant to see how everybody else
is responding, and we're hoping that with anonymity people will tell us
what they really think," says Elizabeth Gillette, the CAP instructional
designer who is helping to plan the program and who says participants
should try to stay for the full day. "The more people we have in the room,
the better cross-section we have, the more we will know what is really
going on in the world of pathology. Then we will discover what we need
to create to help them do their jobs."
Anonymity is said to be a key reason for the success of personal response
technology when it is used in business and education. "We are going to
ask demographic questions at the beginning of the course," Gillette says.
"We don't track individuals by name, but we do like to know if the answer
to a question came from someone with more than 10 years' experience or
who specializes in cytopathology, or someone from a commercial lab, for
example." When the demographic data and participant responses have been
tallied, they'll be looking for trends and differences among the groups.
Participants will also have access to pre-meeting resources to be posted
on the CAP Web site. "We're going to post material on what you should
include in a molecular report, in an immunohistochemistry report, a surgical
pathology report, and so on," Dr. Hammond says. The resources will eventually
be provided to the Council on Scientific Affairs task force that will
implement the workshop's educational mandates.
"We need to know what pathologists really need," Dr. Hammond says. At
the end, there will be an hourlong session about potential reporting issues
that the CAP will address. "We'll get everyone to vote on what they think
is the most critical and decide how we should look at those things. We're
not going to tell them—we're going to ask them to tell us."
Mariann Stephens is a writer in Chicago.