Implications of an expertise model for surgical skills training

The search for improved, more efficacious means of teaching and training surgical skills is essentially a search for means to accelerate the transition of non-expert surgeons to expert surgeons and, in so doing, shorten the usual lengthy pathway to the acquisition of surgical expertise. Drawing on evidence from studies of expert and non-expert surgeons, as well as evidence from studies of expertise in other domains, this paper presents a brief overview of the aspects of skill that appear (likely) to differentiate the expert surgeon from the non-expert. Expert advantages are apparent in some specific aspects of the perceptual, cognitive, motor, attentional and feedback-monitoring components of skilled performance and it is contended that it is these elements, rather than elements on which no expert advantage is apparent, that should form the focal points for skills training programmes. Some constraints to current understanding of surgical expertise are also identified and briefly discussed.