de Andres Crespo Marta, Lykoudis Panagis Michael, Myint Fiona, Berlingieri Pasquale
Centre for Screen-Based Medical Simulation, Royal Free Hospital, London, UK.
Division of Surgery & Interventional Science, Royal Free Campus, UCL, London, UK.
Int J Surg. 2025 May 1;111(5):3399-3413. doi: 10.1097/JS9.0000000000002313.
An increasing number of surgical trainees are taking time out of clinical training for research, parental leave or other interests. A comprehensive review was carried out to evaluate the current evidence on whether and how such time results in surgical skill decay.
A PubMed, Embase, Web of Science, and Cochrane Library search was performed using the phrase: ("skills decay" OR "skills fade") AND "surgery." All relevant literature was analyzed and summarized.
A total of 41 relevant articles were identified. The skills that are most adversely affected by time out of training are technical operative skills and, within those, speed and accuracy in operations. Factors that affect skill decay include the complexity of the task itself, the degree of overlearning (i.e., the skill of the surgeon prior to time out of training) and the retention interval (i.e., the length of time for which the trainee is out of training and whether or not spaced practice is carried out). The articles suggest that simulation may be of assistance in mitigating skill decay; however, this has yet to be fully investigated.
As an increasing number of surgical trainees are taking time away from clinical training for academic research, higher degrees, parental leave, or other interests, further research is required to investigate how to mitigate the resulting surgical skill decay, potentially through the use of simulation.
越来越多的外科住院医师暂停临床培训去从事研究、休产假或追求其他兴趣。开展了一项全面综述，以评估关于这种暂停是否以及如何导致手术技能衰退的现有证据。
使用短语“（技能衰退或技能消退）”和“外科手术”在PubMed、Embase、科学网和考克兰图书馆进行检索。对所有相关文献进行分析和总结。
共识别出41篇相关文章。暂停培训对技能影响最不利的是手术操作技能，其中包括手术速度和准确性。影响技能衰退的因素包括任务本身的复杂性、过度学习程度（即暂停培训前外科医生的技能水平）和保留间隔（即住院医师暂停培训的时间长度以及是否进行间隔练习）。文章表明模拟可能有助于减轻技能衰退；然而，这一点尚未得到充分研究。
由于越来越多的外科住院医师为了学术研究、攻读更高学位、休产假或追求其他兴趣而暂停临床培训，需要进一步研究如何减轻由此导致的手术技能衰退，可能通过使用模拟的方式。
