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J Surg Educ. 2017 Sep 30. pii: S1931-7204(17)30653-0. doi: 10.1016/j.jsurg.2017.09.016. [Epub ahead of print]

Strategies for New Skill Acquisition by Practicing Surgeons.

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The University of Michigan Medical School, Ann Arbor, Michigan. Electronic address:
The University of Michigan Medical School, Ann Arbor, Michigan.
Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Surgery, Wisconsin Surgical Outcomes Research Program, University of Wisconsin School of Medicine, Madison, Wisconsin.
The University of Michigan Medical School, Ann Arbor, Michigan; Center for Healthcare Outcomes and Policy, The University of Michigan, Ann Arbor, Michigan; Department of Surgery, Michigan Medicine, Ann Arbor, Michigan.



To understand how practicing surgeons utilize available training methods, which methods are perceived as effective, and important barriers to using more effective methods.


Online survey designed to characterize surgeon utilization and perception of available training methods.


Two large Midwestern academic health centers.


150 faculty surgeons.


Nominal values were compared using a McNemar's Test and Likert-like values were compared using a paired t-test (IBM SPSS Statistics v. 21.0; New York, NY).


Survey response rate was 81% (122/150). 98% of surgeons reported learning a new procedure or technology after formal training. Many surgeons reported scrubbing in expert cases (78%) and self-directed study (66%), while few surgeons (6%) completed a mini-fellowship. The modalities used most commonly were scrubbing in expert cases (34%) and self-directed study (27%). Few surgeons (7%) believed self-directed study would be most effective, whereas 31% and 16% believed operating under supervision and mini-fellowships would be most effective, respectively. Surgeons believed more effective methods "would require too much time" or they had "confidence in their ability to implement safely."


Practicing surgeons use a variety of training methods when learning new procedures and technologies, and there is disconnect between commonly used training methods and those deemed most effective. Confidence in surgeon's ability was cited as a reason for this discrepancy; and surgeons found time associated with more effective methods to be prohibitive.


Medical Knowledge; Patient Care; Practice Based Learning and Improvement; Systems Based Practice; continuing medical education; minimally invasive surgery; surgery; surgical education

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