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Surgeon Fear in the Operating Room and Its Link to Identity: A Constructivist Grounded Theory Study
Johanna N Riesel1,2,3, Melanie Hammond2,3, Carol-Anne Moulton2,4,5
1Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Annals of Surgery
|May 12, 2025
Summary
Most surgeons experience operating room (OR) fear, often linked to identity threat and impacting personal life. Enhancing identity resilience and emotion regulation is crucial for surgical training and practice.
Area of Science:
- Psychology
- Medical Education
- Surgical Practice
Background:
- Fear significantly impacts surgeon judgment, risk tolerance, and decision-making.
- Limited research exists on the phenomenon of surgeon fear within the operating room (OR).
Purpose of the Study:
- To explore the underlying factors contributing to surgeon fear in the OR.
- To understand how fear affects surgeons' professional and personal lives.
Main Methods:
- Constructivist grounded theory approach.
- Semi-structured interviews with 18 attending surgeons across 14 surgical subspecialties.
- Iterative data collection and analysis using theoretical sampling.
Main Results:
- The majority of surgeons reported experiencing fear in the OR.
- Fear was often perceived as an identity threat, particularly for surgeons with lower identity resilience.
- Identity enmeshment led to OR events negatively impacting surgeons' personal lives.
Conclusions:
- Surgeon fear in the OR is a prevalent issue.
- Identity management and emotion regulation are critical components of surgical education and practice.
- Addressing surgeon fear is essential for improving surgical performance and well-being.
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