The psychological impact of adverse events on urology trainees

O’Meara, Sorcha; D’Arcy, Frank; Dowling, Catherine; Walsh, Kilian

doi:10.1007/s11845-022-03202-8

Cited by 8 publications

(12 citation statements)

References 33 publications

(60 reference statements)

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“…These adverse events had a significant emotional and psychological toll on the affected surgeon, with some effects even lasting more than two years. Negative effects on subsequent clinical practice such as defensive practice, decreased job satisfaction was also reported by previous studies in this area [ 15 , 16 , 22 , 25 – 27 ]. Commonly reported emotions in this study, including sadness, guilt, anxiety and embarrassment, was echoed by previous studies as well [ 10 – 12 , 14 , 16 , 22 , 25 , 28 ].…”

Section: Discussionsupporting

confidence: 68%

“…Negative effects on subsequent clinical practice such as defensive practice, decreased job satisfaction was also reported by previous studies in this area [ 15 , 16 , 22 , 25 – 27 ]. Commonly reported emotions in this study, including sadness, guilt, anxiety and embarrassment, was echoed by previous studies as well [ 10 – 12 , 14 , 16 , 22 , 25 , 28 ]. Although not explored in this study, several factors may affect the extent of emotional sequelae.…”

Section: Discussionsupporting

confidence: 68%

“…Moving forward, normalising emotional responses, encouraging disclosure, whilst making use of current platforms such as M&M meetings would be an optimal suggestion to cultivate a more positive work culture [ 10 , 48 ]. In instances where surgeons had supportive environments, they shared that M&M meetings aided their learning [ 17 ], and they felt more comfortable speaking with their colleagues [ 11 , 13 , 15 , 21 , 22 ]. By enhancing the support network for surgeons and fostering a nurturing workplace atmosphere, we can enhance the notable positive outcomes following adverse events, or posttraumatic growth [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

“…Through multiple team discussions, as well as consultation with a research psychologist and sociologist, iterations and reference to previous studies [ 11 , 20 – 22 ], a 42-item web-based questionnaire was developed using a systematic closed and open approach focused on assessing five main domains: (1) Surgeon’s demographic, (2) Surgeon’s personal experience with adverse events and adverse events reporting, (3) Emotional and psychological impact of event, (4) Physical impact of event, and (5) Perceived support systems. The questionnaire was piloted with five doctors to refine its clarity and wording.…”

Section: Methodsmentioning

confidence: 99%

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Intraoperative adverse events among surgeons in Singapore: a multicentre cross-sectional study on impact and support

Yaow,

Ng,

Chong

et al. 2024

BMC Health Serv Res

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Background It is known that many surgeons encounter intraoperative adverse events which can result in Second Victim Syndrome (SVS), with significant detriment to their emotional and physical health. There is, however, a paucity of Asian studies in this space. The present study thus aimed to explore the degree to which the experience of an adverse event is common among surgeons in Singapore, as well as its impact, and factors affecting their responses and perceived support systems. Methods A self-administered survey was sent to surgeons at four large tertiary hospitals. The 42-item questionnaire used a systematic closed and open approach, to assess: Personal experience with intraoperative adverse events, emotional, psychological and physical impact of these events and perceived support systems. Results The response rate was 57.5% (n = 196). Most respondents were male (54.8%), between 35 and 44 years old, and holding the senior consultant position. In the past 12 months alone, 68.9% recalled an adverse event. The emotional impact was significant, including sadness (63.1%), guilt (53.1%) and anxiety (45.4%). Speaking to colleagues was the most helpful support source (66.7%) and almost all surgeons did not receive counselling (93.3%), with the majority deeming it unnecessary (72.2%). Notably, 68.1% of the surgeons had positive takeaways, gaining new insight and improving vigilance towards errors. Both gender and surgeon experience did not affect the likelihood of errors and emotional impact, but more experienced surgeons were less likely to have positive takeaways (p = 0.035). Individuals may become advocates for patient safety, while simultaneously championing the cause of psychological support for others. Conclusions Intraoperative adverse events are prevalent and its emotional impact is significant, regardless of the surgeon’s experience or gender. While colleagues and peer discussions are a pillar of support, healthcare institutions should do more to address the impact and ensuing consequences.

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Section: Discussionsupporting

confidence: 68%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Intraoperative adverse events among surgeons in Singapore: a multicentre cross-sectional study on impact and support

Yaow,

Ng,

Chong

et al. 2024

BMC Health Serv Res

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“…This finding is consistent with 2 prior survey studies, which found that trainees felt unprepared to cope with the personal impact of complications and would welcome formal instruction. 48 , 49 There are several potential ways in which surgical training programs could incorporate this component of professional development. For instance, setting expectations about the inevitability of adverse events early in training would likely promote destigmatization.…”

Section: Discussionmentioning

confidence: 99%

Surgeon and Surgical Trainee Experiences After Adverse Patient Events

Ginzberg,

Gasior,

Passman

et al. 2024

JAMA Netw Open

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ImportanceAdverse patient events are inevitable in surgical practice.ObjectivesTo characterize the impact of adverse patient events on surgeons and trainees, identify coping mechanisms, and assess whether current forms of support are sufficient.Design, Setting, and ParticipantsIn this mixed-methods study, a validated survey instrument was adapted and distributed to surgical trainees from 7 programs, and qualitative interviews were conducted with faculty from 4 surgical departments in an urban academic health system.Main Outcomes and MeasuresThe personal impact of adverse patient events, current coping mechanisms, and desired forms of support.ResultsOf 216 invited trainees, 93 (43.1%) completed the survey (49 [52.7%] male; 60 [64.5%] in third postgraduate year or higher; 23 [24.7%] Asian or Pacific Islander, 6 [6.5%] Black, 51 [54.8%] White, and 8 [8.6%] other race; 13 [14.0%] Hispanic or Latinx ethnicity). Twenty-three of 29 (79.3%) invited faculty completed interviews (13 [56.5%] male; median [IQR] years in practice, 11.0 [7.5-20.0]). Of the trainees, 77 (82.8%) endorsed involvement in at least 1 recent adverse event. Most reported embarrassment (67 of 79 trainees [84.8%]), rumination (64 of 78 trainees [82.1%]), and fear of attempting future procedures (51 of 78 trainees [65.4%]); 28 of 78 trainees (35.9%) had considered quitting. Female trainees and trainees who identified as having a race and/or ethnicity other than non-Hispanic White consistently reported more negative consequences compared with male and White trainees. The most desired form of support was the opportunity to discuss the incident with an attending physician (76 of 78 respondents [97.4%]). Similarly, faculty described feelings of guilt and shame, loss of confidence, and distraction after adverse events. Most described the utility of confiding in peers and senior colleagues, although some expressed unwillingness to reach out. Several suggested designating a departmental point person for event debriefing.Conclusions and RelevanceIn this mixed-methods study of the personal impact of adverse events on surgeons and trainees, these events were nearly universally experienced and caused significant distress. Providing formal support mechanisms for both surgical trainees and faculty may decrease stigma and restore confidence, particularly for underrepresented groups.

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The psychological burden of major surgical complications in visceral surgery

Mehdorn,

Danker,

Mehdorn

2024

Langenbecks Arch Surg

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Background Complications are common after major visceral surgery. Besides the patients, also surgeons may experience negative feelings by the patients suffering. Some studies have evaluated the mental burden caused by complications, mainly focusing on residents in different surgical specialties. No evidence exists on the mental burden of board-qualified visceral surgeons in Germany. Materials and Methods A point prevalence study was conducted using an online questionnaire. For the inclusion of participants, all departments of visceral surgery at German university hospitals were addressed. The objective of the online questionnaire was to elaborate the perception of complications and the coping mechanisms used by the surgeons with the aim to characterize the mental burden and possible improvement strategies. Results A total of 113 questionnaires were answered, 98 being complete. 73.2% of the participants were male, 46.9% were consultants and had a working experience of 11–20 years. Most common specialties were colorectal and general surgery and 91.7% claimed to have caused complications Clavien-Dindo grade IV or V. Subsequently, predominant feelings were anger, grief, self-doubt and guilt. The fear of being blamed by colleagues or to lose reputation were high. Especially female and younger surgeons showed those fears. Coping mechanisms used to overcome those negative feelings were interaction with friends and family (60.6%) or proactive training (59.6%). Only 17.2% of the institutions offered professional support. In institutions where no support was offered, 71.6% of the surgeons asked for support. Conclusion Surgical complications cause major psychological burden in surgeons in German university hospitals. Main coping mechanisms are communication with friends and families and professional education. Vulnerable subgroups, such as younger surgeons, may be at risk of suffering more from perceived mental distress. Nonetheless, the majority did not receive but asked for professional counselling. Thus, structured institutional support may ameliorate care for both surgeon and patient.

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The psychological impact of adverse events on urology trainees

Cited by 8 publications

References 33 publications

Intraoperative adverse events among surgeons in Singapore: a multicentre cross-sectional study on impact and support

Intraoperative adverse events among surgeons in Singapore: a multicentre cross-sectional study on impact and support

Surgeon and Surgical Trainee Experiences After Adverse Patient Events

The psychological burden of major surgical complications in visceral surgery

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