Prevention of surgical skill decay.

The U.S. military medical community spends a great deal of time and resources training its personnel to provide them with the knowledge and skills necessary to perform life-saving tasks, both on the battlefield and at home. However, personnel may fail to retain specialized knowledge and skills if they are not applied during the typical periods of nonuse within the military deployment cycle, and retention of critical knowledge and skills is crucial to the successful care of warfighters. For example, we researched the skill and knowledge loss associated with specialized surgical skills such as those required to perform laparoscopic surgery (LS) procedures. These skills are subject to decay when military surgeons perform combat casualty care during their deployment instead of LS. This article describes our preliminary research identifying critical LS skills, as well as their acquisition and decay rates. It introduces models that identify critical skills related to laparoscopy, and proposes objective metrics for measuring these critical skills. This research will provide insight into best practices for (1) training skills that are durable and resistant to skill decay, (2) assessing these skills over time, and (3) introducing effective refresher training at appropriate intervals to maintain skill proficiency.