Cognitive Task Analysis: Bringing Olympic Athlete Style Training to Surgical Education

Surg Innov. 2015 Aug;22(4):406-17. doi: 10.1177/1553350614556364. Epub 2014 Nov 12.


Background: Surgical training is changing and evolving as time, pressure, and legislative demands continue to mount on trainee surgeons. A paradigm change in the focus of training has resulted in experts examining the cognitive steps needed to perform complex and often highly pressurized surgical procedures.

Objective: To provide an overview of the collective evidence on cognitive task analysis (CTA) as a surgical training method, and determine if CTA improves a surgeon's performance as measured by technical and nontechnical skills assessment, including precision, accuracy, and operative errors.

Methods: A systematic literature review was performed. PubMed, Cochrane, and reference lists were analyzed for appropriate inclusion.

Results: A total of 595 surgical participants were identified through the literature review and a total of 13 articles were included. Of these articles, 6 studies focused on general surgery, 2 focused on practical procedures relevant to surgery (central venous catheterization placement), 2 studies focused on head and neck surgical procedures (cricothyroidotomy and percutaneous tracheostomy placement), 2 studies highlighted vascular procedures (endovascular aortic aneurysm repair and carotid artery stenting), and 1 detailed endovascular repair (abdominal aorta and thoracic aorta). Overall, 92.3% of studies showed that CTA improves surgical outcome parameters, including time, precision, accuracy, and error reduction in both simulated and real-world environments.

Conclusion: CTA has been shown to be a more effective training tool when compared with traditional methods of surgical training. There is a need for the introduction of CTA into surgical curriculums as this can improve surgical skill and ultimately create better patient outcomes.

Keywords: colorectal surgery; evidence-based medicine/surgery; gastric surgery; orthopedic surgery; simulation; surgical education.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Clinical Competence
  • Computer Simulation
  • Education, Medical / methods*
  • General Surgery / education*
  • Humans
  • Models, Theoretical*
  • Surgeons / education*
  • Surgeons / statistics & numerical data*