This study assessed shared decision-making among thousands of surgeons, revealing critical insights for improving patient outcomes.

• Only 1.2% of surgeons achieved top scores in shared decision-making, while 64% of patients felt their surgeons performed adequately.
• Male surgeons, those in cardiothoracic specialties, and surgeons with over 31 years of practice were linked to lower decision-making scores.

Surgeons should consider these factors for enhancing patient engagement and aligning treatments with patient values.

• Performance could improve through targeted training initiatives based on individual surgeon assessments.

This study develops a practical implementation framework for integrating data-driven surgical metrics into training, improving assessment reliability and trainee outcomes.

• Engaged 54 trainees and trainers from 13 countries through workshops to inform framework development.
• Prioritized real-time feedback for technical skills and dashboards for non-technical skills to provide objective performance insights.

Making surgical training more data-driven could significantly reduce assessor bias and enhance patient safety.

• Future research will evaluate the framework’s real-world effectiveness in surgical education.

Surgeons play a crucial role in tackling persistent cancer care disparities among marginalized populations.

• Marginalized groups experience higher cancer risks but often miss essential screenings and guidelines.
• Continued efforts are necessary to identify root causes and craft targeted interventions.

Implementing these strategies can lead to more equitable oncologic outcomes for all patients.

• Collaboration with multidisciplinary teams and community stakeholders is vital for sustainable change.