Department of General Surgery, Royal Alexandra Hospital, Paisley, UK.
School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK.
Colorectal Dis. 2024 Aug;26(8):1608-1616. doi: 10.1111/codi.17078. Epub 2024 Jun 21.
Surgeon personality is a factor influencing rectal anastomotic decision-making. However, it is unclear how or why this may be the case, or what aspects of personality are involved. The aim of this study was to investigate the views of colorectal surgeons on how their individual personality may influence variation in anastomotic decision-making.
Purposive sampling was used to invite certified UK-based colorectal surgeons to participate, with individual interviews used for data collection. Participants were recruited until ongoing data review indicated no new codes were generated (i.e. data sufficiency). Data were analysed thematically following Braun and Clarke's six-step framework.
Seventeen colorectal surgeons (eight female, nine male) participated. Two key themes relating to personality and decision-making were identified: (1) surgeon development and training and (2) patient-surgeon interactions, each with relevant subthemes. Surgeons described how their personality may influence patients' postoperative outcomes (e.g. decision-making, team working and communication) and potential mechanisms for how their personality may influence operative risk-taking. Following anastomotic leakage, surgeons described a disproportionate sense of guilt and responsibility. There appears to be a significant transition in responsibility from trainee to newly appointed consultant, which may be part of the 'hidden curriculum' of surgical training.
Colorectal surgeons have described their perceptions of how personality traits may impact variation in decision-making and patient outcomes for the first time. Early career surgeons felt ill-prepared for the level of guilt experienced when managing complications. Surgeons appear open to personality assessment if this was through an educational lens, with the aim of improving decision-making following complications and overall performance.
外科医生的个性是影响直肠吻合决策的一个因素。然而，目前尚不清楚这是如何或为什么会发生，或者涉及到个性的哪些方面。本研究旨在调查结直肠外科医生对其个人个性如何影响吻合决策变化的看法。
采用目的性抽样邀请认证的英国结直肠外科医生参与，采用个人访谈进行数据收集。参与者的招募持续进行，直到持续的数据分析表明没有新的代码生成（即数据充足）。采用 Braun 和 Clarke 的六步框架进行主题分析。
17 名结直肠外科医生（8 名女性，9 名男性）参与了研究。确定了与个性和决策相关的两个关键主题：（1）外科医生的发展和培训，（2）医患互动，每个主题都有相关的子主题。外科医生描述了他们的个性如何影响患者的术后结果（例如决策、团队合作和沟通）以及个性可能影响手术冒险的潜在机制。吻合口漏发生后，外科医生描述了一种不成比例的内疚感和责任感。从实习医生到新任命的顾问，责任似乎有一个显著的转变，这可能是外科培训“隐性课程”的一部分。
结直肠外科医生首次描述了他们对个性特征如何影响决策和患者结果变化的看法。早期职业外科医生感到在处理并发症时感到内疚，他们对此准备不足。外科医生似乎对以教育为重点的个性评估持开放态度，目的是在处理并发症和整体表现方面改善决策。
