Performance psychology workshops for surgical trainees: A prospective pilot study on anxiety and mental toughness

Performance anxiety and resilience are critical determinants of surgical trainee performance.

To evaluate the feasibility and preliminary impact of a brief performance psychology intervention, combining individual self-regulation with team-based performance strategies, on performance anxiety and mental toughness in surgical trainees.

In a prospective single-arm pilot and feasibility study in a university teaching hospital, nine surgical trainees from various subspecialities enrolled, with eight completing follow-up assessments. The intervention comprised two immersive workshops over two weeks, integrating individual and team-based psychological skills grounded in the biopsychosocial model of stress, challenge-threat appraisal, and high performance principles. Participants completed the Sport Anxiety Scale-2 and the Mental Toughness Evaluation Questionnaire-2 (MTE-2) at baseline (T0), three weeks (T1), and three months (T2).

Eight of nine trainees (89%) completed all follow-up assessments, and the programme was delivered as planned. Mental toughness (MTE-2) improved over time (p = 0.002), and a median improvement of 580 points (95% CI 200 to 880) was sustained at three months. Most marked improvement seen in pre-performance distraction control. Anxiety (SAS-2) showed a short-term reduction, clearest for the worry subscale, though returned to baseline at three months. Frequency of technique use did not correlate with outcomes.

This brief high-performance psychology intervention was feasible and acceptable and was associated with short-term reductions in performance anxiety and sustained improvements in mental toughness in surgical trainees. These findings support the feasibility of integrating time-efficient psychological training in surgical education. Larger, controlled studies are required to confirm efficacy and mechanisms.