Surgeon and Surgical Trainee Experiences After Adverse Patient Events.

Area of Science:

• Medical Education
• Surgical Practice
• Patient Safety

Background:

• Adverse patient events are unavoidable in surgical practice.
• These events can profoundly affect the mental and emotional well-being of surgeons and trainees.
• Understanding these impacts is crucial for developing effective support systems.

Purpose of the Study:

• To characterize the impact of adverse patient events on surgeons and trainees.
• To identify coping mechanisms employed by surgical professionals.
• To assess the sufficiency of current support structures and explore desired forms of assistance.

Main Methods:

• A mixed-methods approach was utilized, combining survey data from surgical trainees with qualitative interviews of surgical faculty.
• Validated survey instruments were adapted and distributed to trainees across seven programs.
• Faculty interviews were conducted within four surgical departments at an urban academic health system.

Main Results:

• A high percentage of trainees (82.8%) reported involvement in recent adverse events, experiencing embarrassment, rumination, and fear of future procedures.
• Female trainees and those from non-White ethnic backgrounds reported more severe negative consequences.
• Both trainees and faculty experienced significant distress, including guilt, shame, and loss of confidence, with trainees desiring discussions with attending physicians for support.

Conclusions:

• Adverse patient events are nearly universally experienced by surgical professionals and cause significant distress.
• Formal support mechanisms are needed to address the psychological impact of these events.
• Such support can help decrease stigma, restore confidence, and particularly benefit underrepresented groups in surgery.