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JAMA. 1914;LXIII(9):763-765. doi:10.1001/jama.1914.02570090049014.
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At one time the surgeon was almost the only skilled mechanical worker with a craft knowledge analyzed, recorded and disseminated. Now the man with the shovel and the apprentice bricklayer have outstripped him in technic, for in their activities essential motions, tools, and economy of effort have been studied and standardized and taught, while we who think ourselves open-minded scientists look askance at propositions to apply to ourselves measurements of action and efficiency and fatigue, record of errors, instructions in type, motion-training, submission to discipline and new adjustments of function and cooperation. The high average of equipment, dexterity, information, conscientious care and self-sacrificing humanity in operating-rooms, great and small, here and abroad, are matters which some years of planned travel and laborious note-taking heartily attest; but evidence is not lacking that advance is very irregular where it might be all along the line, and erratic rather than on any studied


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