Driven to Innovate: Why Practicing Surgeons Learn New Procedures and Technologies

Todd A Jaffe, BBA, Steven J Hasday, BS, Meghan C Knol, MS, Jason C Pradarelli, MS, Justin B Dimick, MD, MPH. University of Michigan

INTRODUCTION: New surgical procedures and technologies are continuously being developed and introduced. For practicing surgeons, the rationale to seek training in order to learn and implement these new procedures and technologies is personal, variable and largely unknown.  Our aim is to better understand the motives behind surgeons’ choices to learn something new.

METHODS AND PROCEDURES: A 22 question survey was created and 77 faculty in the Department of Surgery at a large Midwestern Academic Health Center were invited to participate in the on-line survey via email.  Survey respondents were asked to indicate the frequency with which they feel internal motivations and external pressures when deciding to learn new procedures or technologies, then provide on an anchored 5-point Likert-like scale (1 = “None;” 5 = “A Great Role”) how great a role specific internal and external factors played in their decision-making process.  Response values were compared using Wilcoxon signed rank tests. 

RESULTS: The survey response rate was 71% (55/77).  44% of respondent surgeons have implemented 1-3 new procedures since completing their formal training, 35% have implemented 4-6, and 21% have implemented 7 or more.  Nearly all surgeons (98%) indicated they have felt internal motivation, and 78% felt external pressure to learn a new procedure or technology.  Surgeons felt greater internal motivation compared with external pressures (mean of 3.15 vs. 2.37; p<0.01) when deciding to learn something new.  When considering their internal motivations, surgeon’s indicated that “Improvement for Patients” and “Enjoyment in Learning Something New” provided the greatest impetus in the decision to learn, with “Improvement for Patients” regarded as the most important factor (4.54 vs. 3.72, p<0.01).  Surgeons responded that “Financial Gains” played little role (1.78) in their decision-making. 

Surgeons indicated the greatest external pressure was provided by the “Medical Community to Remain Current” (3.79), “Patient Request” (3.26), and “Competition with Other Practices” (3.09).  Pressures from “Hospital/Provider Groups” (1.88) and “Device Manufacturers” (1.77) played a substantially smaller role than the other three (both p<0.01).

CONCLUSION: Our results indicate that among academic surgeons, internal motivations play a greater role in the decision to learn new procedures or technologies than do external pressures.  The desire to improve outcomes for patients was the most important motivator, though pressures from the medical community, patient demand, and a desire to remain current play a substantial role as well.  

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