The effect of surgical complications on trauma and orthopaedic trainees

Complications can be devastating for patients, but the 'second victim' phenomenon is increasingly being acknowledged, whereby the surgeons involved in the complication are adversely affected by such complications. For trainees, who are early into their surgical careers and are on a learning curve, such events can be formative or pivotal in their careers. Additionally, as temporary rotating members of the departments they work in, there can often be educational, interpersonal or workplace demands that amplify such effects, and a lack of professional ties that allow them to comfortably discuss complications with temporary or new work colleagues.

An online questionnaire was designed and distributed to UK Trauma and Orthopaedic trainees. Sixty-five trainees responded from across ten deaneries.

There were significant negative effects of complications on trainees, including sadness (77.8%), anxiety (63.5%), guilt (69.8%) and embarrassment (63.5%). A total of 40.3% reported complications affected them outside of work. Only 60.9% felt well supported. Only 22.2% were offered formal support. In addition, 66.7% have witnessed another trainee struggle after a complication. Only 15.6% felt their training programme adequately prepares them to deal with the emotional impact of complications.

Adverse effects of complications on Trauma and Orthopaedic trainees are a prevalent issue. There are no ubiquitous formal structures in place to support trainees affected by complications. Nonblame, informal debrief sessions were cited repeatedly as beneficial.