What the Surgeon of Tomorrow Needs to Know About Evidence-Based Surgery

The role of collegial interaction in continuing professional development

“…This corresponds to primary care findings that information sharing among colleagues can increase confidence in decision making when evidence is lacking, conflicting or not applicable to individuals. 10,14,23 Several perceived benefits of collegial interaction were noted. Participants said that clinical outcomes included patient satisfaction with decision making, more appropriate care delivery, and better continuity.…”

“…9 Limited time, access to sources of evidence, and skill in critical appraisal are also barriers to evidence-based practice. [10][11][12] Furthermore, evidence may be difficult to apply to individual patients, or patient preferences may differ from recommended practice. 13 In these circumstances, decisions must incorporate judgment that is based on clinical expertise.…”

“…[15][16][17][18][19][20][21][22] Sharing of "professional wisdom" among physicians is thought to increase confidence in the appropriateness of an approach for an individual patient. 10,14 Interviews with general practitioners found they devised care plans primarily on the basis of their own experience and that of colleagues. 23 The authors concluded that evidence could best be shared with physicians by exploiting existing collegial networks.…”

“…Evidence-based care is particularly challenging in surgery, for which there are few randomized trials to guide practice. 10,[24][25][26][27] We are not aware of any thorough studies examining the information needs of general surgeons, who, as do general practitioners, care for patients with a wide variety of conditions including cancer, a leading cause of premature death worldwide. One study reported that surgeons more frequently seek information from colleagues than family physicians do.…”

Self-directed learning needs, patterns, and outcomes among general surgeons

“…-level constraints. [14][15][16][17][18][19][20] Increasingly, physicians seek text-based or explicit, codified knowledge on the Internet but such searching often takes place at home after work and uncovers useful knowledge half of the time. 21,22 Colleagues represent an important source of experiential or tacit knowledge when codified evidence is lacking or professional judgment is needed.…”