Its shot placement. Plain and simple. And you have to be comfortable with what you shoot. And shoot it a lot. And shoot it again. Run 50 yards and fast bullseye. Run 100 yards and fast bullseye. Do 30 pushups and bullseye.
.45 acp is awesome if you can hit with it. .357 mag 125gr hollow point is just as bad.
How can you shoot determines.