[The surgical learning curve].

PubMed, vol. 164

Abstract

Surgical perfection takes years of training and a learning curve to optimize outcomes. This creates an ethical dilemma: although healthcare systems benefit from training new surgeons, the learning curve may cause suboptimal outcomes for the first patients a resident operates on. Can collective interest for the betterment of healthcare be combined with the wellbeing of the individual patient? We argue that this is possible under controlled circumstances. Residency programmes can optimize the learning curve of the trainee by active and extensive supervision: the 'See one, do one' mentality is outdated, even in relatively simple procedures. Residents can improve their skills by using hands-on training on animals or cadavers, or by re-watching their own procedures. It is possible that despite all preventative measures, the effect of the learning curve on surgical outcomes is inevitable and necessary where new surgeons are trained within regular healthcare systems. Ultimately, practice makes perfect.

Authors 3

1. Marike L. D. Broekman Aachen Computational Neurosciences Outcomes Center Harvard Medical School

   Brigham and Women's Hospital · Harvard University · Leiden University Medical Center · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Computational Neurosciences Outcomes Center, dep. Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Verenigde Staten (tevens: Haaglanden Medisch Centrum, afd. Neurochirurgie, Den Haag en LUMC, afd. Neurochirurgie, Leiden)

   Contact: M.L.D. Broekman (m.broekman@haaglandenmc.nl)

2. Alexander F. C. Hulsbergen Aachen Computational Neurosciences Outcomes Center Harvard Medical School

   Brigham and Women's Hospital · Harvard University · Leiden University Medical Center · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Computational Neurosciences Outcomes Center, dep. Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Verenigde Staten (tevens: Haaglanden Medisch Centrum, afd. Neurochirurgie, Den Haag en LUMC, afd. Neurochirurgie, Leiden)

3. I A R RamlochanTewarie Aachen Computational Neurosciences Outcomes Center Harvard Medical School

   Brigham and Women's Hospital · Harvard University · Leiden University Medical Center · Stichting Haaglanden Medisch Centrum

   Affiliation as printed

   Computational Neurosciences Outcomes Center, dep. Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Verenigde Staten (tevens: Haaglanden Medisch Centrum, afd. Neurochirurgie, Den Haag en LUMC, afd. Neurochirurgie, Leiden)