Article Text

Download PDFPDF
Skill decay in surgeons deployed on military operations: a systematic review
  1. Tim Stansfield1 and
  2. N Tai2,3
  1. 1Vascular Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Centre For Trauma Sciences, The Royal London Hospital, London, UK
  3. 3Research and Clinical Innovation, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Tim Stansfield, vascular surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK; tim.stansfield{at}nhs.net

Abstract

Introduction Decay of surgical skills due to paucity of opportunity to operate is a potential threat to patients being cared for by the Defence Medical Services while on operational deployment. Our aim was to review the literature regarding skill decay in the trained surgeon in order to understand how it may affect clinical performance and patient outcomes. We also wished to survey the likely causes of such decay and possible means of mitigation.

Methods A systematic review of the literature was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study bias assessment was also undertaken. Content summaries for the papers included study design and methodology, participant level of experience, measures and magnitude of effect, duration of no practice, and study limitations.

Results Five papers met the selection criteria. There were insufficient quantitative data on the impact of surgical skill decay on patient outcome, surgeon performance or mitigation strategies, and a meaningful quantitative synthesis could not be undertaken.

Conclusions This systematic review of the literature found very little specific evidence confirming or refuting surgical skill decay in trained surgeons, with measurement of decay hampered by the lack of an accepted methodology. Studying this in the deployed setting may offer a firmer evidence base from which to generate policy. Potential mitigation strategies are discussed.

PROSPERO registration number ID260846.

  • trauma management
  • surgery
  • qualitative research
  • education & training (see medical education & training)

Data availability statement

No data are available.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes

  • Contributors TS conceived the idea for the manuscript. TS undertook the literature review. NT and TS wrote and reviewed the manuscript. TS is the guarantor of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.