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Are More Experienced Surgeons Better? The Association Between Surgeons’ Experience and Performance

Surgical care is often linked to adverse events with a wide variation in mortality rates across hospitals. Given that lives are at risk a lot of efforts go into improving care. Most of those efforts focus on technological advancement. Only a few focus on the impact of human factors, such as the surgeon’s performance.

“Professional expertise results from a gradual improvement in performance within a specialty.” In surgery, experts reach their peak performance “at age 30 to 50 years—that is, after about ten years’ experience in their speciality.” Only a few studies have explored the association between clinicians’ experience and performance. In surgery, “performance can be assessed by the occurrence of postoperative complications, and experience can be measured by the surgeon’s age or time spent in practice.”

Are more experienced surgeons better? That is what a fascinating new research paper explores: “We aimed to model the association between the experience and performance of surgeons on postoperative complications in thyroid surgery.”

The results were surprising. The most experienced surgeons were not the best. “We observed a concave association between surgeons’ experience and their case mix adjusted performance, suggesting that surgeons aged 35 to 50 years provided the safest care.”

They conclude:

Our findings also suggest that a surgeon cannot achieve or maintain top performance passively by accumulating experience, which raises concerns about ongoing training and motivation throughout a career that extends several decades. Solutions to help surgeons avoid poor outcomes could include simulation and proctoring in the early years of their careers, continuous monitoring of performance, and targeted retraining if appropriate. Individual feedback based on outcome indicators might increase awareness about performance and improve safety in surgical practice.

Sounds like they could use a coach.

Source: Influence of experience on performance of individual surgeons in thyroid surgery: prospective cross sectional multicentre study