Teaching the slowing-down moments of operative judgment

Surgical judgment has been an elusive construct to define, let alone teach or assess. A recent study has characterized a phenomenon called slowing down when you should, and suggests it is a hallmark for operative judgment. This research highlights areas where surgical judgment can be identified and therefore taught more explicitly in the operating room. Through the identification of these slowing-down moments and an understanding of how control is negotiated between surgeon and trainee during these moments, this article uses several theoretic frameworks to understand how teaching judgment in the operating room can be optimized.