The principle tenant of disruptive technologies is that a revolutionary change challenges core knowledge and practice, and requires the surgeon to reevaluate his or her practice in order to adapt to the change, frequently on less-than-complete information or proof. This past century, and especially the past 20 years, has produced repeated assault on many aspects of surgery: mini mally invasive approach, robotics, surgical simulation, transplantation, and many more. No longer is change being slowly and methodically introduced one change at a time; rather, the surgeon is being buffeted from many sides at once. Interdisciplinary knowledge is required to keep up with these changes, a quite impossible task in lieu of the many other stresses to clinical practice. The traditional approach to life-long learning through occasional continuing medical education (CME) courses must be supplemented by self education through journals, Web-based education, and other information-based systems. Keeping abreast of the latest surgical technologies, techniques, and procedures will require more than a weekend course; it must include subsequent mentoring and proctoring until proficiency is obtained before incorporating the new technology into a surgeon's clinical practice. And outcomes must be documented to prove that the acquisition of new skills and procedures has been done safely. Finally, it is imperative for surgeons to carefully address the moral and ethical implications of the new technologies, to ensure that not only can it be introduced safely, but that the technology will not have unintended long-term consequences. The burden upon surgeons has never been so great.

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