# Surgeons as High-Performance Athletes: Applying Player Development Strategies from Professional Sport to Enhance Surgical Performance

> **NIH NIH R01** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2024 · $709,977

## Abstract

General thoracic and adult cardiac (“cardiothoracic”) surgical procedures are among the most frequently
performed high-risk inpatient procedures. Despite technological advances and quality improvement initiatives
(e.g., outcomes reporting), major complications remain common (10-34%), vary by hospital (4%-35%), increase
the risk of mortality (atrial fibrillation: 3%; cardiac arrest: 49%) and add $6K-$34K to expenditures.
Emerging data linking surgeon operative performance, encompassing technical and non-technical (e.g.,
communication, decision-making) skills, with patient outcomes after non-cardiac surgery reveals that surgical
technical skills are necessary yet alone are insufficient for achieving high performance. Researchers have
evaluated both faculty and trainee (i.e., interns, residents and fellows) cardiothoracic surgeon operative
performance with validated taxonomies; yet, this work has: (1) often been conducted within simulated scenarios
lacking medical and psychological challenges of real-world surgery and (2) lacked structure to improve and
monitor performance over one’s career. Relevant to these observations are developments within the discipline
of sport (e.g., professional tennis) that have pioneered advanced performance parameters for athletes. The U.S.
Tennis Association (USTA), for instance, develops data-driven analytics applied to annotated in-game video to
analyze technical, tactical and physical ability and emotional regulation as important tools to develop athletes,
especially during high-intensity situations. The application of USTA’s Player Development approach to surgeons
uniquely advances real-world surgeon-specific operative performance parameters given the increased use of
digital technology and similarities between athletes and surgeons that extend to the following surgical domains:
(1) technical (e.g., economy of motion); (2) tactical (e.g., sequencing of tasks); (3) cognitive (e.g., situation
awareness); and (4) physical (e.g., stamina, ergonomics). While biomarkers reflecting a player’s physiology (e.g.,
heart rate variability) and human factors (e.g., fatigue, task load) are measured within sport, their role in
explaining additional variance in surgical outcomes beyond operative performance ratings is understudied.
Our long-term goal is to enhance surgical outcomes by identifying and promoting the wide-scale adoption of
evidence-based operative performance practices. The objective of this proposal is to obtain validity evidence
supporting the development of a surgeon-specific performance index for cardiothoracic surgery. The proposed
multi-center study leverages our team’s expertise in applying data analytics to recorded, real operative video,
and a unique partnership with USTA’s Player Development program. We have the following aims: (1) Develop a
multidomain cardiothoracic surgeon operative performance index; (2) Identify biomarkers associated with a
surgeon’s operative performance; and (3) Qualitatively assess d...

## Key facts

- **NIH application ID:** 10994967
- **Project number:** 1R01HL175879-01
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Joseph A Dearani
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $709,977
- **Award type:** 1
- **Project period:** 2024-07-15 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10994967

## Citation

> US National Institutes of Health, RePORTER application 10994967, Surgeons as High-Performance Athletes: Applying Player Development Strategies from Professional Sport to Enhance Surgical Performance (1R01HL175879-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10994967. Licensed CC0.

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