Tired female nurse sitting on floor in hospital

(© Leonid - stock.adobe.com)

PITTSBURGH — In the high-stakes world of heart surgery, failure can be a matter of life and death. But for the surgeons who hold their patients’ hearts in their hands, failure is also an opportunity to learn, to improve, and to push the boundaries of what’s possible. However, a groundbreaking new study by researchers Sunkee Lee and Jisoo Park reveals that we aren’t always able to learn from our mistakes.

Their study finds that even the most dedicated surgeons can cease to benefit from the knowledge that comes out of their own mistakes.

Imagine you’re a cardiac surgeon. Each time you step into the operating room, you carry with you the weight of your past successes and failures. Every patient lost is a tragedy, but also a chance to reflect, to analyze, and to ask yourself what you could have done differently. This process of learning from failure is a crucial part of your growth as a surgeon. But what happens when the failures start to pile up? At what point does the well of learning run dry, and the burden of repeated failures become too much to bear?

This is the question that Lee and Park set out to answer in their study of 307 cardiothoracic surgeons performing coronary artery bypass graft (CABG) surgeries in California over a 16-year period. The researchers were interested in understanding how a surgeon’s performance – measured by their patient’s risk-adjusted survival rate – changed as a function of their accumulated failures over time.

The results, published in the open-access Strategic Management Journal, were striking. Initially, as expected, surgeons’ performance improved as they experienced and learned from failures. Each patient lost provided valuable information that could be applied to future surgeries. However, this learning effect was not linear. Instead, the researchers found an inverted-U-shaped relationship between a surgeon’s accumulated failures and their performance.

In other words, there was a tipping point. Up to a certain number of failures, surgeons continued to learn and improve. But beyond this threshold, the learning effect tapered off and eventually reversed. Surgeons who had experienced a high number of failures actually performed worse than those with fewer failures under their belt.

Stressed, tired doctors or nurses
The study finds that even the most dedicated surgeons can stop benefiting from the knowledge that comes out of their own mistakes. (© Robert Kneschke – stock.adobe.com)

So what’s going on here? Lee and Park suggest that this pattern is driven by a complex interplay of factors that influence a surgeon’s ability to learn from their mistakes. On the one hand, each failure provides a new opportunity to gain knowledge and insight. But on the other hand, repeated failures take an emotional and psychological toll. Surgeons are human, after all, and the weight of losing patient after patient can lead to feelings of guilt, self-doubt, and helplessness.

As failures accumulate, these negative emotions can start to drown out the motivation to learn. Surgeons may become discouraged, questioning their own abilities and wondering if they’re cut out for the job. They may start to attribute failures to external factors beyond their control, rather than looking inward for areas of improvement. In essence, they may give up on learning from their own mistakes.

However, not all surgeons reach this tipping point at the same time. The study found that surgeons with certain characteristics were able to sustain the learning effect for longer before succumbing to the detrimental impact of repeated failures. Surgeons who had received elite training at top institutions, who had achieved board certification, and who specialized in patient care rather than research or teaching all showed a higher threshold for failure before their performance began to decline.

The researchers suggest that these factors may contribute to a surgeon’s perceived ability to learn – their confidence in their own skills and their belief that they can turn failures into opportunities for growth. Surgeons with more training and specialized experience may feel better equipped to analyze and learn from their mistakes and, thus, be more resilient in the face of repeated setbacks.

So, what can we take away from this study? For one, it highlights the incredible mental and emotional challenges faced by those in high-stakes professions like surgery. The pressure to perform, the burden of responsibility, and the inevitability of failure can take a heavy toll over time. It’s crucial that surgeons and other medical professionals have access to support systems and resources to help them cope with these stresses and maintain their motivation to learn and improve.

But the study also has broader implications for how we think about learning from failure in any field. It suggests that there may be a limit to how much we can gain from our own mistakes and that pushing past this limit may actually be counterproductive. Sometimes, the best thing we can do after a string of failures is to take a step back, regroup, and approach the problem from a fresh angle, rather than stubbornly pushing forward and expecting different results.

Ultimately, the path to success is paved with failure. But it’s also important to recognize when that path has taken a turn and it’s time to chart a new course. For the cardiac surgeons in this study, and for all of us striving to learn and grow in our own lives, the key is to find that delicate balance – to embrace failure as a teacher but also to know when enough is enough.

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StudyFinds publishes digestible, agenda-free, transparent research summaries that are intended to inform the reader as well as stir civil, educated debate. We do not agree nor disagree with any of the studies we post, rather, we encourage our readers to debate the veracity of the findings themselves. All articles published on StudyFinds are vetted by our editors prior to publication and include links back to the source or corresponding journal article, if possible.

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Associate Editor