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Title: Surgeons' stress and coping strategies : investigating psychologgical components of surgical performance
Author: Wetzel, Cordula Magdalena
ISNI:       0000 0001 3566 3718
Awarding Body: Imperial College London
Current Institution: Imperial College London
Date of Award: 2008
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Background stress can impair professional performance. Surgery is a highly demanding medical specialty, and performance is a critical factor for patient safety. Nevertheless, research on surgeon's stress, coping strategies and effects on surgical performance is lacking. Moreover, educational programmes addressing stress management for surgeons have not been established. Objectives i a) To identify potential stress factors, surgical coping strategies and effects on performance qualitatively b) To investigate the effects of stress and coping on surgical performance experimentally c) To develop and evaluate evidence-based surgical stress management training Description of Studies Study 1: Surgeons perceptions of stress, their coping strategies and perceived effects of stress on their performance were investigated. 16 participants were interviewed. Data were analysed using a grounded theory approach. stress was experienced by all surgeons and perceived as detrimental to their performance, but experienced surgeons reported sophisticated coping strategies. Study 2: Based on the findings on potential stress factors in study 1 a simulated operation was developed. A realistic, standardised scenario using simulated carotid endarterectomy (CEA), an advanced surgical procedure, in the simulated operating theatre (SOT) at St MaryJs Hospital was evaluated and found to be a suitable research tool assessing surgical stress and performance. Study 3: The effect of stress and coping on surgical performance during simulations were investigated experimentally. Surgeons' stress levels were assessed using physiological measures, self- and observer-ratings. Coping strategies were explored qualitatively using postexperimental interviews, and the number of reported coping strategies used was calculated. Surgeons' technical skills, team communication skills and the quality of the operative result were rated. Cognitive performance was also assessed using self-reported measures. A. Linear Regression analysis has shown a significant effect of stress and coping 0!1 surgical performance. Study 4: A surgical stress management intervention training was developed using a randomised control design with 8 SUbjects per group. All participants carried out 2 simulated CEAs. The training group received information on surgical stress management and training on practising and applying these strategies. Surgeons' performance. coping strategies and stress levels during the simulated CEA were assessed and comparisons made between the intervention group and the control group. Additionally participants' feedback on the effectiveness of the training and feasibility was obtained. Discussion The findings and implications of the impact of stress on surgeons' performance, coping strategies as non-technical surgical sknls, and the effectiveness of stress management training for surgeons are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available