Morbidity and Mortality (M&M) conferences are designed to explore systems that contribute to medical error or adverse outcomes in patient care. PSNet offers an online version of such conferences with presentation of cases and expert commentaries discussing relevant safety issues. In training programs, growth of M&M conferences also serves to teach important principles of quality and safety through a variety of different frameworks. This study shares a structured systems audit framework that was applied to M&M conferences to enhance resident awareness of systems issues. The framework facilitated discussion of improvement opportunities and fostered a positive safety culture in exploring the events presented. The authors provide a number of practical tools for adoption and share examples of using these tools in M&M conferences.