One of my students has been thinking about surgical education, and so I've been thinking about how to trace the influence of good medical education through to the improved outcomes for patients. I drew this diagram for my student, and thought I'd share it here in my blog in case anyone wanted to comment on it. I have enough friends and family with MDs that perhaps someone will want to discuss this.
My main point, I think, is that patient outcomes are influenced by many things, and the skill of a surgeon, while probably the single most significant influence on outcomes over which we have much control, is probably relatively small in comparison to about a dozen other things over which we have some control. And so, if we want to find the connection between surgical skill and patient outcomes we will need to design exceedingly detailed studies that control for all these other variables.
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