Variety and Experience: Learning and Forgetting in the Use of Surgical Devices

46 Pages Posted: 2 Jun 2015 Last revised: 9 Sep 2016

See all articles by Kamalini Ramdas

Kamalini Ramdas

London Business School - Department of Management Science and Operations

Khaled Saleh

Southern Illinois University at Carbondale - School of Medicine

Steven N. Stern

Stony Brooke University

Haiyan Liu

University of South Florida, Department of Economics

Date Written: August 29, 2016

Abstract

We use a unique, hand-collected dataset to examine learning and forgetting in hip replacement surgery as a function of a surgeon’s experience with specific surgical device versions and the time between their repeat uses. We also develop a generalizable method to correct for the left-censoring of device-version-specific experience variables that is a common problem in highly granular experience data, using Maximum Simulated Likelihood Estimation (MSLE) with simulation over unobservables conditional on observables. Even for experienced surgeons, the first usage of certain device versions can result in at least a 32.4% increase in surgery duration, hurting quality and productivity. Furthermore, with the passage of time, surgeons can forget knowledge gained about the use of particular devices. For certain devices, when the time gap between repeat uses increases from its median to its 75th percentile, surgery duration increases by about 3.4%. The high productivity and quality costs associated with device variety suggest that the gain from a new device design needs to be large enough to compensate for the short term disadvantages of starting up on a new learning curve and of increasing the chances of knowledge depreciation over time.

Keywords: Product Variety, Learning and Forgetting, Experience Curves, Productivity, Health Care

Suggested Citation

Ramdas, Kamalini and Saleh, Khaled and Stern, Steven N. and Liu, Haiyan, Variety and Experience: Learning and Forgetting in the Use of Surgical Devices (August 29, 2016). Available at SSRN: https://ssrn.com/abstract=2612899 or http://dx.doi.org/10.2139/ssrn.2612899

Kamalini Ramdas (Contact Author)

London Business School - Department of Management Science and Operations ( email )

Sussex Place
Regent's Park
London, London NW1 4SA
United Kingdom

Khaled Saleh

Southern Illinois University at Carbondale - School of Medicine ( email )

P.O. Box 19620
Springfield, IL 62794-9620
United States

Steven N. Stern

Stony Brooke University

Melville Library N4004
Stony Brook, NY 11794-3384
United States

Haiyan Liu

University of South Florida, Department of Economics ( email )

4202 E. Fowler Avenue
CMC206A
Tampa, FL 33620
United States

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