Development of surgical skills and performance

The main objectives of this article are to help surgeons understand some important factors that influence surgical performance, and provide them with some advice to improve their surgical skills. Progression of surgical skill through novice-expert continuum and factors that influence this progression are discussed. One of these influential factors is the surgeon’s stress resilience. Scientific evidence regarding physiologic processes that underlie stress resilience and the effectiveness of psychological tools to improve this innate characteristic is reviewed. The impact of self-esteem and the importance of deliberate practice on achieving higher levels of surgical performance are also discussed. Innate characteristics are not rigid and can be improved by a variety of psychological tools including mental practice and self-talk. Stress management training programs and courses would be beneficial for surgeons with limited stress latitude and resilience. Deliberate practice is a powerful and efficient strategy to improve surgical performance. Key words: Deliberate practice; Dexterity; Expert; Stress; Surgical performance; Surgical skill.