Skill decay in surgeons deployed on military operations: a systematic review

Abstract

IntroductionDecay 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.MethodsA 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.ResultsFive 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.ConclusionsThis 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.

Management and prevention of surgeon skill decay during US military deployment: a response to the UK

“…We commend Stansfield and Tai for their article “Skill decay in surgeons deployed on military operations: a systematic review” 1. The authors conducted a thorough systematic review investigating the impact low combat casualty care (LCCC) deployments have on surgeon skill and patient outcomes.…”