Article Text

Download PDFPDF
Learning curves in surgery: variables, analysis and applications
  1. Epaminondas Markos Valsamis,
  2. Tarak Chouari,
  3. Christopher O'Dowd-Booth,
  4. Benedict Rogers,
  5. David Ricketts
  1. Trauma and Orthopaedics Department, Brighton and Sussex University Hospitals, Brighton, UK
  1. Correspondence to Epaminondas Markos Valsamis, Trauma and Orthopaedics Department, Brighton and Sussex University Hospitals, Brighton BN2 5BE, UK; markosvalsamis{at}


Learning curves graphically represent the relationship between learning effort and learning outcome. Learning curves are increasingly used in research, the design of randomised controlled trials, the assessment of competency, healthcare education and training programme design. In this review we have outlined the principles behind plotting learning curves, described the common methods used to analyse learning curves, how to interpret learning curves, the multitude of learning models, their applications and potential pitfalls, and the importance of a mathematically rigorous approach to learning curve analytics.

  • medical education & training
  • surgery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All authors contributed to the writing of this work. EMV: conception, analysis, writing and revision of manuscript, responsible for overall content as guarantor. TC: writing and editing of manuscript. CO-B: writing and editing of manuscript. BR, DR: writing and editing of manuscript and supervision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on request.