Performance anxiety amongst trauma and orthopaedic surgical trainees

This study aims to assess performance anxiety amongst orthopaedic trainees. Operating is equivalent in its skill level, both dexterous and mental, to that of elite sport. This study uses a slightly altered version of the validated Sports Competition Anxiety Test (SCAT), making it relevant to operating, rather than to sport, to evaluate peri-operative stress and anxiety in orthopaedic surgeons.

The SCAT questionnaire was sent to trainees across 3 UK. deaneries via email. A score of <17 suggests low-levels of anxiety, 17-24 suggests medium-levels of anxiety and >24 suggest high-levels of anxiety. Data was anonymised except from training grade and sex.

109 of 273 (40%) responded to the survey, 71% of respondents were male (n = 77). The mean SCAT score amongst Core Surgical Trainees was 16.9 (n = 21, range 12-23), Specialist Trainees years 3-5 was 18.7 (n = 51, range 12-28), Specialist Trainees years 6-8 was 16.8 (n = 26, range 11-24) and consultants was 16 (n = 11, range 11-28). Across all groups, when sub-divided by sex, females had higher mean scores, this was statistically significant for Specialist Trainees years 3-5 (p = 0.029) and Specialist Trainees years 6-8 (p = 0.042) groups.

Surgical performance anxiety exists amongst orthopaedic surgeons, with females scoring higher than males. Five respondents scored "high-levels of anxiety" including 2 consultants level surgeons, suggesting experience does not entirely eliminate anxiety. Stress and anxiety are known to lead to surgical mistakes and "burnout" amongst surgeons which is highly topical at present. It is important to highlight this significant issue and it could be taken forward as a national survey to evaluate further.