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Exploring variation in surgical practice: does surgeon personality influence anastomotic decision-making?

Bisset, Carly N.; Ferguson, Eamonn; MacDermid, Ewan; Stein, Sharon L.; Yassin, Nuha; Dames, Nicola; Keller, Deborah S.; Oliphant, Raymond; Parson, Simon H.; Cleland, Jennifer; Moug, Susan J.; Plato Project Steering Group Collaborators

Exploring variation in surgical practice: does surgeon personality influence anastomotic decision-making? Thumbnail


Carly N. Bisset

Professor of Health Psychology

Ewan MacDermid

Sharon L. Stein

Nuha Yassin

Nicola Dames

Deborah S. Keller

Raymond Oliphant

Simon H. Parson

Jennifer Cleland

Susan J. Moug

Plato Project Steering Group Collaborators


BACKGROUND: Decision-making under uncertainty may be influenced by an individual's personality. The primary aim was to explore associations between surgeon personality traits and colorectal anastomotic decision-making. METHODS: Colorectal surgeons worldwide participated in a two-part online survey. Part 1 evaluated surgeon characteristics using the Big Five Inventory to measure personality (five domains: agreeableness; conscientiousness; extraversion; emotional stability; openness) in response to scenarios presented in Part 2 involving anastomotic decisions (i.e. rejoining the bowel with/without temporary stomas, or permanent diversion with end colostomy). Anastomotic decisions were compared using repeated-measure ANOVA. Mean scores of traits domains were compared with normative data using two-tailed t tests. RESULTS: In total, 186 surgeons participated, with 127 surgeons completing both parts of the survey (68.3 per cent). One hundred and thirty-one surgeons were male (70.4 per cent) and 144 were based in Europe (77.4 per cent). Forty-one per cent (77 surgeons) had begun independent practice within the last 5 years. Surgeon personality differed from the general population, with statistically significantly higher levels of emotional stability (3.25 versus 2.97 respectively), lower levels of agreeableness (3.03 versus 3.74), extraversion (2.81 versus 3.38) and openness (3.19 versus 3.67), and similar levels of conscientiousness (3.42 versus 3.40 (all P <0.001)). Female surgeons had significantly lower levels of openness (P <0.001) than males (3.06 versus 3.25). Personality was associated with anastomotic decision-making in specific scenarios. CONCLUSION: Colorectal surgeons have different personality traits from the general population. Certain traits seem to be associated with anastomotic decision-making but only in specific scenarios. Further exploration of the association of personality, risk-taking, and decision-making in surgery is necessary.

Journal Article Type Article
Acceptance Date May 14, 2022
Online Publication Date Jul 19, 2022
Publication Date Oct 14, 2022
Deposit Date Oct 8, 2022
Publicly Available Date Oct 11, 2022
Journal The British journal of surgery
Print ISSN 0007-1323
Electronic ISSN 1365-2168
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 109
Issue 11
Pages 1156-1163
Keywords Surgery
Public URL
Publisher URL


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