The role of imaging, deliberate practice, structure, and improvisation in approaching surgical perfection

Abstract

When art meets science.the overlap of practice, surgery, structure and improvisation. Central MessageWhen art meets science.the overlap of DP, surgery, structure, and improvisation.See Editorial Commentaries pages 1337 and 1339.

See one—practice—do one—practice—teach one—practice: The importance of practicing outside of the operating room in surgical training

“…Isolated drills would fail to encapsulate the more complex, dynamic, and nontechnical aspects of the operation such as teamwork, communication, judgment, and leadership. 40,41 Dearani and colleagues 42 astutely noted the importance of improvisation in surgery, especially in less-structured or routine operations, which may require creating or reconstructing structures. Although these critiques are valid and the optimal simulation models for rehearsing such dynamic abilities remain to be explored, they should not deter participation among trainees for the following reasons.…”

“…The benefits of conducting drills are to be able to provide trainees with focused, individually tailored tasks in low-risk, low-pressure circumstances, such that these techniques become second-nature, and can augment the overall efficiency and efficacy of their training experience. As Dearani and colleagues 42 write, mastery entails handling basic motor functions without explicit attention, allowing greater focus on higher-level parameters.…”

Bending the Curve: The Importance of Expertise

“…Recently, our own STSA member Joe Dearani and colleagues [6] published an Expert Opinion piece in the Journal of Thoracic and Cardiovascular Surgery on the role of deliberate practice, imaging, and structure in their quest for surgical perfection. The authors make the point that the use of technology, particularly three-dimensional imaging and review of operative videos, can enhance deliberate practice and improve performance.…”

It's a long way to the other side of the table

“…Deliberate practice has been well-studied in many fields and eloquently written about by Dearani and others as it portends to cardiac surgery. [1][2][3] Simply stated, deliberate practice involves focused, deliberate tasks to improve performance with coaching and feedback. 4 It has clearly been shown to be effective in cardiothoracic training.…”