Surgeons Are Not Pilots: Is the Aviation Safety Paradigm Relevant to Modern Surgical Practice?

Petrut Gogalniceanu*, Francis Calder, Chris Callaghan, Nick Sevdalis, Nizam Mamode

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Error in surgery is common, although not always consequential. Surgical outcomes are often compared to safety data from commercial aviation. This industry's performance is frequently referenced as an example of high-reliability that should be reproduced in clinical practice. Consequently, the aviation-surgery analogy forms the conceptual framework for much patient safety research, advocating for the translation of aviation safety tools to the healthcare setting. Nevertheless, overuse or incorrect application of this paradigm can be misleading and may result in ineffective quality improvement interventions. This article discusses the validity and relevance of the aviation-surgery comparison, providing the necessary context to improve its application at the bedside. It addresses technical and human factors training, as well as more novel performance domains such as professional culture and optimization of operators’ condition. These are used to determine whether the aviation-surgery analogy is a valuable source of cross-professional learning or simply another safety cliché.

Original languageEnglish
Pages (from-to)1393-1399
Number of pages7
JournalJournal of Surgical Education
Issue number5
Publication statusPublished - 1 Sept 2021


  • aviation safety
  • human factors
  • nontechnical skills
  • Patient Care
  • patient safety
  • Professionalism
  • quality improvement
  • surgical simulation
  • Systems-Based Practice


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