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Differences in Preoperative Preparation Between Novice Surgeons and Experts: A Scoping Review
Keita Ishido1, Kotoe Kiriyama1, Saseem Poudel1
1Department of Gastroenterological Surgery II, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Background:
Patient outcomes are strongly influenced by the experience of the surgeon. Expert surgeons typically exhibit broader situational awareness and risk assessment, whereas novice surgeons tend to have more focused planning and a higher cognitive load under stressful conditions. This scoping review aimed to clarify the differences in preoperative preparation between novice and expert surgeons. By mapping existing studies, we highlighted critical gaps and proposed directions for research in surgical education.
Methods:
Following the PRISMA-ScR guidelines, we searched the PubMed and Cochrane Library databases for English-language articles published through October 2024. The search terms were: "expert," "novice," "preoperative," and "decision-making and preparation", although these were supplemented by hand-searching reference lists. Ten studies comparing the preoperative communication, treatment planning, and decision-making of novice and expert surgeons were included.
Results:
Our data indicated that expert surgeons demonstrated more proactive communication, broader situational awareness, and stronger checklist adherence than novice surgeons. Nontechnical skills generally improved with experience, although there was evidence of a plateau at advanced stages. Three studies reported a higher preoperative planning accuracy among experts, whereas 1 study showed no significant differences. Novice surgeons tended to focus on immediate tasks, while experts considered long-term risks and management strategies. Reflective learning, mentorship, and simulation-based practice were frequently emphasized as the keys to bridging this gap in knowledge, highlighting the multifaceted nature of surgical expertise.
Conclusion:
Preoperative preparation differs between novice and expert surgeons. This observation supports the need for structured mentorship and targeted training to accelerate skills development. Such interventions may improve patient safety and outcomes, particularly in high-stress settings. Further research should clarify how these strategies influence long-term outcomes under high-stress conditions.
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