Acquiring and maintaining lifelong expertise in surgery
1Division of Education, American College of Surgeons, Chicago, IL.
Surgery
|November 9, 2019
Summary
Surgical expertise is multidimensional, requiring both general and adaptive skills for optimal patient outcomes. Modern training emphasizes deliberate practice, feedback, and an expert performance approach for efficient skill development.
Area of Science:
- Surgical Education and Training
- Expertise Development
- Medical Professionalism
Background:
- Surgical expertise is crucial for patient outcomes and encompasses knowledge, skills, and attributes.
- It is multidimensional, domain-specific, and context-specific, including general and adaptive expertise.
- Traditionally acquired through experience, modern approaches focus on planned development.
Purpose of the Study:
- To explore the multifaceted nature of surgical expertise.
- To review traditional and contemporary methods for developing surgical expertise.
- To highlight the importance of adaptive expertise and the expert performance approach.
Main Methods:
- Literature review and synthesis of concepts related to surgical expertise.
- Analysis of traditional experience-based learning versus structured training methods.
- Discussion of the role of deliberate practice, feedback, reflection, and metacognition.
Main Results:
- Surgical expertise is characterized by pattern recognition, rapid decision-making, and efficiency.
- Adaptive expertise is vital for handling unexpected situations and complex surgical environments.
- The expert performance approach, incorporating deliberate practice and feedback, is a key framework.
Conclusions:
- Surgical expertise requires a blend of general and adaptive skills, developed through structured training.
- Simulation, coaching, and communities of practice support expertise acquisition and maintenance.
- Professional organizations play a vital role in supporting surgeon development.
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