ABSTRACT
A learning curve can be de ned simply as an improvement in performance over time. This improvement tends to be most rapid at first and then tails off over time. Learning curves have been observed for many health technologies [1] from relatively simple procedures such as ber-optic intubation [2] to complex surgical procedures (for example, minimal access interventions [3]) and also the assessment of diagnostic technologies [1]. In surgery, this issue has been described as the most intractable of the obstacles to conducting randomized trials [4,5].
