Imagine a surgeon is hired based on strong professional recommendations and qualifications, yet subsequent to being hired, many of the surgeon’s patients are readmitted to the clinic with serious postoperative complications. It is later discovered that the surgeon lacks sufficient manual dexterity and was therefore making critical technical errors during surgery that compromised surgical success and patient health. Such an occurrence, though surprising, is not unheard of.
Surgical skills, which include both technical and nontechnical abilities, are often acquired through an apprenticeship-based system that hasn’t changed considerably over the past century. Although there are systematic processes to assess competencies during training, certification, and recertification of surgeons, they tend to be subjective, inconsistent, and focused primarily on nontechnical skills. This can lead to high variability in surgical performance across surgical specialties, potentially compromising patient care and introducing ethical quandaries.