The Pygmalion effect in surgical training-how labeling and expectations affect trainees: a narrative review

Area of Science:

• Surgical Education
• Psychology
• Organizational Behavior

Background:

• Expectation effects (Pygmalion, Galatea, Golem) are known in education but understudied in surgical training.
• Supervisor expectations and reputational labeling can influence trainee learning, entrustment, performance, and well-being.

Purpose of the Study:

• To review how supervisor expectations and reputational labeling affect surgical trainees.
• To examine the impact on learning opportunities, entrustment, performance, and well-being.

Main Methods:

• Narrative review of literature from educational and organizational psychology.
• Analysis of emerging research in surgical education, including qualitative and experimental studies.

Main Results:

• Expectations influence learners via socio-emotional climate, instructional input, performance opportunities, and feedback.
• Trainees engage in impression management; prior reputation biases assessments.
• Negative expectations decrease self-efficacy and increase anxiety and burnout; positive expectations enhance skill acquisition and resilience.

Conclusions:

• Expectation effects are a powerful, modifiable factor in surgical education.
• Training programs should foster growth-oriented expectations and minimize prejudicial labeling.
• Creating a culture of coaching, transparency, and psychological safety improves trainee development and patient care.