Dr. Congeniality: Understanding the Importance of Surgeons' Nontechnical Skills Through 360° Feedback

Physician performance is a complex construct that is broadly defined by technical and nontechnical components. The primary aim of this study was to identify which Big Five personality traits (openness, conscientiousness, extraversion, agreeableness, and emotional stability) in surgeons were related to patient satisfaction and teamwork performance in a surgical setting. A secondary aim of this study was to examine the specific perceptions of physician behavior related to patient satisfaction and teamwork performance.

Orthopedic surgeons received anonymous multisource 360° feedback from managers, colleagues, nurses, technicians, and trainees. Personality traits were categorized with a modified Delphi Consensus technique using the Big Five framework. Patient satisfaction was measured using retrospective Clinician & Group-Consumer Assessment of Healthcare Providers and System (CG-CAHPS) data. Teamwork performance was measured using the Quality PULSE 360 Teamwork Index.

Research was performed at a large academic medical center in the northeastern United States.

Participants in this study included a sample of 24 orthopedic surgeons.

Backward stepwise regressions were used to determine which model with the most variance used the fewest explanatory variables. Personality traits acted as predictor variables in the regression models and patient satisfaction and teamwork performance were utilized as outcome variables. The higher the physicians' emotional stability, the higher patients' overall satisfaction (β = 0.41, p = 0.04) and willingness to recommend them to other patients (β = 0.45, p = 0.03). Furthermore, high emotional stability was related to effective surgical teams as rated by team members (β = -0.75, p = 0.00) such that the more emotionally stable physicians were, the higher their teamwork rating by colleagues.

Both physicians-in-training and in-practice physicians may benefit from engaging in empathic and constructive behaviors with patients and team members.