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BJS Prize 2 Exploring variation in surgical practice: the colorectal surgeon's personality influences anastomotic decision-making in rectal cancer

Bisset, Carly; Ferguson, Eamonn; Oliphant, Raymond; Macdermid, Ewan; Moug, Susan

Authors

Carly Bisset

EAMONN FERGUSON eamonn.ferguson@nottingham.ac.uk
Professor of Health Psychology

Raymond Oliphant

Ewan Macdermid

Susan Moug



Abstract

Background The influence of internal surgeon-specific factors, such as personality, on cognitive bias and decision-making in surgery is not well understood. These factors may be particularly influential in clinical cases where there is a high degree of equipoise. This study aimed to explore personality traits that may influence anastomotic decision-making in rectal cancer. Methods Colorectal surgeons were invited via social media to participate in a 2-part online survey (Snap11). The survey included: 1) 44-item Big Five Inventory (personality), 2) 30-item DOSPERT (risk-taking), 3) 3-item Cognitive Reflection Test (thinking style), and twenty hypothetical patient scenarios involving rectal anastomotic decisions. Results 186 certified colorectal surgeons participated with 127 completing both parts (68.3%). 143 participants in this cohort were aged 30–49 years (79.6%) and 131 participants were male (70.4%). Surgeons scored higher than average population levels for emotional stability (degree of even-temperedness; 3.25 vs 2.97), with lower levels of agreeableness (ability to cooperate with others; 3.03 vs 3.74) and openness (creativity; 3.19 vs 3.67). Personality influenced anastomotic decision-making in specific circumstances e.g., high levels of openness predicted stoma formation when providing a second opinion, whereas high levels of extraversion predicted stoma formation when the patient was a staff member. Early career surgeons were highly influenced by colleague criticism following recent anastomotic leakage. Conclusions Surgeon personality influences anastomotic decision-making in difficult circumstances. Colleague support is vital following anastomotic leakage and is influential upon early career surgeons’ subsequent decision-making. Personality is modifiable through experiences, therefore targeted educational interventions (e.g. reflexivity) may enable surgeons to recognize their own cognitive biases.

Citation

Bisset, C., Ferguson, E., Oliphant, R., Macdermid, E., & Moug, S. (2022). BJS Prize 2 Exploring variation in surgical practice: the colorectal surgeon's personality influences anastomotic decision-making in rectal cancer. British Journal of Surgery, 109(Supplement_5), Article znac246.002. https://doi.org/10.1093/bjs/znac246.002

Journal Article Type Article
Acceptance Date May 14, 2022
Online Publication Date Aug 9, 2022
Publication Date Aug 9, 2022
Deposit Date Nov 16, 2022
Journal British Journal of Surgery
Print ISSN 0007-1323
Electronic ISSN 1365-2168
Peer Reviewed Peer Reviewed
Volume 109
Issue Supplement_5
Article Number znac246.002
DOI https://doi.org/10.1093/bjs/znac246.002
Keywords Surgery
Public URL https://nottingham-repository.worktribe.com/output/13738974
Publisher URL https://academic.oup.com/bjs/article/109/Supplement_5/znac246.002/6660333