McDonald J, Orlick T, Letts M
Faculty of Health Sciences, University of Ottawa, Ontario, Canada.
J Pediatr Orthop. 1995 Sep-Oct;15(5):691-7. doi: 10.1097/01241398-199509000-00027.
The purpose of this study was to assess mental factors related to surgical excellence among surgeons. In-depth interviews were conducted with 33 highly proficient surgeons involved in high- (51%) and low- (49%) mortality-risk surgery. A "Surgeon Interview Guide" was developed for eliciting relevant qualitative and quantitative data. The success elements from Orlick's "Model of Human Excellence," based on work with elite athletes, were used as the basic framework for the qualitative analysis of the interview transcripts. Of the three major readiness factors rated by the surgeons--mental, technical, and physical--surgeons rated mental readiness as most important for performance excellence in surgery; 49, 41, and 10%, respectively. Mental readiness was also the factor that showed the most significant change between successful and disappointing surgical performances (p = 0.003). The following mental factors were identified as important among highly qualified surgeons and in surgeons performing high-mortality-risk surgery: commitment, self-belief, positive imagery, mental readiness, full focus, distraction control, and constructive evaluation. Highly successful experienced surgeons perform at an exceptional level largely because of the quality of their mental skills. Residents in surgery may benefit from systematic mental training in similar mental skills. This approach has been effective in other high-performance disciplines and could likewise play a meaningful role in helping surgeons improve their mental readiness for the challenges they face.
本研究的目的是评估外科医生中与卓越手术表现相关的心理因素。对33名参与高（51%）、低（49%）死亡风险手术的高技能外科医生进行了深入访谈。开发了一份“外科医生访谈指南”以获取相关的定性和定量数据。基于与精英运动员合作的奥里克“人类卓越模型”中的成功要素，被用作访谈记录定性分析的基本框架。在外科医生评定的三个主要准备因素——心理、技术和身体因素中，外科医生认为心理准备对手术中的卓越表现最为重要，分别占49%、41%和10%。心理准备也是成功与令人失望的手术表现之间变化最为显著的因素（p = 0.003）。以下心理因素在高素质外科医生和进行高死亡风险手术的外科医生中被确定为重要因素：投入、自信、积极想象、心理准备、全神贯注、分心控制和建设性评估。非常成功的经验丰富的外科医生之所以表现卓越，很大程度上是因为他们心理技能的质量。外科住院医生可能会从类似心理技能的系统心理训练中受益。这种方法在其他高性能领域已被证明有效，同样也可以在帮助外科医生提高应对所面临挑战的心理准备方面发挥有意义的作用。
