Making Surgical Top Guns: Maximizing Time at the Controls by Integrating Military Aviation Techniques Into Surgical Instruction

Medicine has successfully adopted various aviation practices, such as checklists and closed-loop communication, to enhance safety and efficiency. The world of aviation also offers key lessons for teaching in a high-stakes, real-world environment. This article proposes that the U.S. Air Force aviation pedagogical techniques of Root Cause Analysis and Desired Learning Objectives present a model that can easily be adapted to surgical education. Integrated within a Prepare–Brief–Do–Debrief cycle, this methodology maximizes trainee autonomy and safety by iteratively correcting errors through verbal guidance or manual intervention when necessary. This approach offers a scalable, repeatable framework for achieving graduated surgical entrustment and improving trainee development in high-stakes environments.