BMJ  2004;329:424 (21 August), doi:10.1136/bmj.38176.444745.63 (published 6 August 2004)

Commentary

The learning curve

¹ Guy's and St Thomas' Hospital, London SE1 9RT tom.treasure@ukgateway.net

The first 150 words of the full text of this article appear below.

Bridgewater and colleagues have studied the surgical results of surgeons in each of their first four years of independent practice and report that there is a learning curve.¹ To explain the concept of a learning curve a surgeon writing in the New Yorker magazine chose for his example the insertion of a central venous line into the subclavian vein by the subclavicular route.² His chosen example was a good one. Pneumothorax and major bleeding are common in inexperienced hands and the technique merits special precautions, but in Gawande's experience it is taught, resident to resident, at the bedside, on a "see one, do one" basis. He uses it to explain the inescapable fact—that there is risk in being a patient. Our duty in providing health care is to get that risk to a minimum while at the same time learning ourselves and training others. As the then President of the . . . [Full text of this article]

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For the things we have to learn before we can do them, we learn by doing them

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bmj.com, 20 Aug 2004 [Full text]

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