Variation in Surgeon Proficiency Scores and Association With Digit Replantation Outcomes

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Abstract
Anders Ericsson1 suggested that innate differences in human ability can be overcome through 10 000 hours of deliberate practice. This notion that “practice makes perfect” is central to surgical training programs. Differences in operative skill among new surgical interns are presumed to equalize after a minimum number of cases, producing surgeons with comparable levels of ability.2 Nevertheless, evidence shows there is significant variation in risk-adjusted outcomes among attending surgeons in various procedures.3-7 To explain this phenomenon, many studies have focused on the positive correlation between a surgeon’s procedure volume and their outcomes. However, these investigations have largely ignored whether a surgeon’s operative proficiency could directly contribute to the equation. A link between surgeon ability and patient outcomes is logical, yet few studies have strived to measure the operative proficiency of attending surgeons and determine its association with outcomes.

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