The effects of stress on surgical performance.

Wetzel, C. M., Kneebone, R., Woloshynowych, M., Nestel, D., Moorthy, K., Kidd, J. and Darzi, A. 2006. The effects of stress on surgical performance. The American Journal of Surgery. 191 (1), pp. 5-10. https://doi.org/10.1016/j.amjsurg.2005.08.034

TitleThe effects of stress on surgical performance.
TypeJournal article
AuthorsWetzel, C. M., Kneebone, R., Woloshynowych, M., Nestel, D., Moorthy, K., Kidd, J. and Darzi, A.
Abstract

Background
Although the general literature on stress and performance is extensive, little is known about specific effects of stress in surgical practice. This qualitative study explored key surgical stressors, their impact on performance, and coping strategies used by surgeons.
Methods
Individual in-depth semistructured interviews with surgeons were analyzed by 2 researchers independently. Key themes were discussed within the research team.
Results
Sixteen interviews were performed, including interviews with consultants (n = 9) and surgeons in training (n = 7). A wide range of intraoperative stressors was identified. Although stress had both positive and negative effects, undue levels of stress impaired judgment, decision making, and communication. Although junior surgeons showed uncertainty about their ability to cope, senior surgeons had developed sophisticated strategies for controlling each situation.
Conclusions
Although stress poses significant risks, coping strategies are not taught explicitly during surgical training. This article presents a framework for categorizing surgical stress and suggests key elements for effective coping strategies.

KeywordsOccupational stress
Surgical performance
Coping strategies
Training
Qualitative research
JournalThe American Journal of Surgery
Journal citation191 (1), pp. 5-10
ISSN0002-9610
Year2006
PublisherElsevier
Digital Object Identifier (DOI)https://doi.org/10.1016/j.amjsurg.2005.08.034
PubMed ID16399098
Web address (URL)https://www.americanjournalofsurgery.com/article/S0002-9610(05)00732-4/fulltext
Publication dates
Published2006

Related outputs

A correlational analysis of COVID-19 incidence and mortality and urban determinants of vitamin D status across the London boroughs
Borna, M., Woloshynowych, M., Schiano-Phan, R., Volpi, E. and Usman, M. 2022. A correlational analysis of COVID-19 incidence and mortality and urban determinants of vitamin D status across the London boroughs. Scientific Reports. 12 (1) 11741. https://doi.org/10.1038/s41598-022-15664-y

Obesity, oxidative DNA damage and vitamin D as predictors of genomic instability in children and adolescents
Usman, M., Woloshynowych, M., Britto, J.C., Bilkevic, I., Glassar, B., Chapman, S., Ford-Adams, M.E., Desai, A., Bain, M., Tewfik, I. and Volpi, E. 2021. Obesity, oxidative DNA damage and vitamin D as predictors of genomic instability in children and adolescents. International Journal of Obesity. 45, p. 2095–2107. https://doi.org/10.1038/s41366-021-00879-2

Food and Mood: Exploring the determinants of food choices and the effects of food consumption on mood among women in Inner London.
Leeds, J., Keith, R. and Woloshynowych, M. 2020. Food and Mood: Exploring the determinants of food choices and the effects of food consumption on mood among women in Inner London. World Nutrition. 11 (1), pp. 68-96. https://doi.org/10.26596/wn.202011168-96

Work conditions, mental workload, and patient care quality: a multisource study in the emergency department.
Weigl, M., Müller, A., Holland, S., Wedel, S. and Woloshynowych, M. 2016. Work conditions, mental workload, and patient care quality: a multisource study in the emergency department. BMJ Quality and Safety. 25, pp. 499-508. https://doi.org/10.1136/bmjqs-2014-003744

A multicentre observational study to evaluate a new tool to assess emergency physicians' non-technical skills
Flowerdew, L., Gaunt, A., Spedding, J., Bhargava, A., Brown, R., Vincent, C. and Woloshynowych, M. 2013. A multicentre observational study to evaluate a new tool to assess emergency physicians' non-technical skills. Emergency Medicine Journal. 30 (6), pp. 437-443. https://doi.org/10.1136/emermed-2012-201237

Teams under pressure in the emergency department: an interview study
Flowerdew, L., Brown, R., Vincent, C. and Woloshynowych, M. 2012. Teams under pressure in the emergency department: an interview study. Emergency Medicine Journal. 29 e2. https://doi.org/10.1136/emermed-2011-200084

Identifying Nontechnical Skills Associated With Safety in the Emergency Department: A Scoping Review of the Literature
Flowerdew, L., Brown, R., Vincent, C. and Woloshynowych, M. 2012. Identifying Nontechnical Skills Associated With Safety in the Emergency Department: A Scoping Review of the Literature. Annals of Emergency Medicine. 59 (5), pp. 386-395. https://doi.org/10.1016/j.annemergmed.2011.11.021

Development and Validation of a Tool to Assess Emergency Physicians' Nontechnical Skills
Flowerdew, L., Brown, R., Vincent, C. and Woloshynowych, M. 2012. Development and Validation of a Tool to Assess Emergency Physicians' Nontechnical Skills. Annals of Emergency Medicine. 59 (5), pp. 376-385. https://doi.org/10.1016/j.annemergmed.2011.11.022

The ABC of Handover: Impact on shift handover in the Emergency Department
Farhan, M., Brown, R., Vincent, C. and Woloshynowych, M. 2012. The ABC of Handover: Impact on shift handover in the Emergency Department. Emergency Medicine Journal. 19, pp. 947-953. https://doi.org/10.1136/emermed-2011-200201

The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department.
Farhan, M., Brown, R., Woloshynowych, M. and Vincent, C. 2012. The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department. Emergency Medicine Journal. 29, pp. 941-946. https://doi.org/10.1136/emermed-2011-200199

Patient safety factors in children dying in a paediatric intensive care unit (PICU): a case notes review study
Monroe, K., Wang, D., Vincent, C., Woloshynowych, M., Neale, G. and Inwald, D.P. 2011. Patient safety factors in children dying in a paediatric intensive care unit (PICU): a case notes review study. BMJ Quality and Safety. 20, pp. 863-868. https://doi.org/10.1136/bmjqs.2010.048504

Stress Management Training for Surgeons - a randomised controlled intervention study
Wetzel, C.M., George, A., Hanna, G.B., Athanasiou, T., Black, S.A., Kneebone, R.L., Nestel, D. and Woloshynowych, M. 2011. Stress Management Training for Surgeons - a randomised controlled intervention study. Annals of Surgery. 253 (3), pp. 488-494. https://doi.org/10.1097/SLA.0b013e318209a594

Factors compromising safety in surgery: stressful events in the operating room
Arora, S., Hull, L., Tierney, T., Nestel, D., Woloshynowych, M., Darzi, A. and Kneebone, R. 2010. Factors compromising safety in surgery: stressful events in the operating room. The American Journal of Surgery. 199 (1), pp. P60-65. https://doi.org/10.1016/j.amjsurg.2009.07.036

The Imperial Stress Assessment Tool (ISAT): A feasible, reliable and valid approach to measuring stress in the Operating Room
Arora, S., Tierney, T., Sevdalis, N., Aggarwal, R., Woloshynowych, M., Nestel, D., Darzi, A. and Kneebone, R. 2010. The Imperial Stress Assessment Tool (ISAT): A feasible, reliable and valid approach to measuring stress in the Operating Room. World Journal of Surgery. 34, pp. 1756-1763. https://doi.org/10.1007/s00268-010-0559-4

The impact of stress on surgical performance: A systematic review of the literature
Arora, S., Sevdalis, N., Nestel, D., Woloshynowych, M., Darzi, A and Kneebone, R 2010. The impact of stress on surgical performance: A systematic review of the literature. Surgery. 147 (3), pp. 318-330. https://doi.org/10.1016/j.surg.2009.10.007

Reflective analysis of safety research in the hospital accident & emergency departments
Wears, R.L., Woloshynowych, M., Brown, R. and Vincent, C.A. 2010. Reflective analysis of safety research in the hospital accident & emergency departments. Applied Ergonomics. 41 (5), pp. 659-700. https://doi.org/10.1016/j.apergo.2009.12.006

The effect of stress and coping on surgical performance during simulations
Wetzel, C.M., Black, S.A., Hanna, G.B., Athanasiou, T., Kneebone, R.L., Nestel, D., Wolfe, J.H.N. and Woloshynowych, M. 2010. The effect of stress and coping on surgical performance during simulations . Annals of Surgery. 251 (1), pp. 171-176. https://doi.org/10.1097/SLA.0b013e3181b3b2be

Managing Intra-operative stress: What do surgeons want from a crisis training programme?
Arora, S., Sevdalis, N., Nestel, D., Tierney, T., Woloshynowych, M. and Kneebone, R. 2009. Managing Intra-operative stress: What do surgeons want from a crisis training programme? The American Journal of Surgery. 197 (4), pp. 537-543. https://doi.org/10.1016/j.amjsurg.2008.02.009

The Care Homes Use of Medicines Study: prevalence, causes and potential harm of medication errors in care homes for older people
Barber, N.D., Alldred, D.P., Raynor, D.K., Dickinson, R., Garfield, S., Jesson, B., Lim, R., Savage, I., Standage, C., Buckle, P., Carpenter, J., Franklin, B., Woloshynowych, M. and Zermansky, A.G. 2009. The Care Homes Use of Medicines Study: prevalence, causes and potential harm of medication errors in care homes for older people. BMJ Quality and Safety. 18, pp. 341-346. https://doi.org/10.1136/qshc.2009.034231

Methodological variability in detecting prescribing errors when evaluating computerised physician order entry
Dean Franklin, B., Birch, S., Savage, I., Wong, I., Woloshynowych, M., Jacklin, A. and Barber, N. 2009. Methodological variability in detecting prescribing errors when evaluating computerised physician order entry. Pharmacoepidemiology and Drug Safety. 18 (11), pp. 992-999. https://doi.org/10.1002/pds.1811

Continuity of care 2006: what have we learned since 2000 and what are policy imperatives now?
Freeman, G., Woloshynowych, M., Baker, R., Boulton, M., Guthrie, B., Car, J., Haggerty, J. and Tarrant, C. 2007. Continuity of care 2006: what have we learned since 2000 and what are policy imperatives now? NCCSDO.

Communication Patterns in a UK Emergency Department
Woloshynowych, M., Davis, R., Brown, R. and Vincent, C. 2007. Communication Patterns in a UK Emergency Department. Annals of Emergency Medicine. 50 (4), pp. 407-413. https://doi.org/10.1016/j.annemergmed.2007.08.001

Patient safety and iatrogenesis
Woloshynowych, M. and Vincent, C. 2007. Patient safety and iatrogenesis. in: Ayers, S., Baum, A., McManus, C., Newman, S, Wallston, K., Weinman, J. and West, R. (ed.) Cambridge Handbook of Psychology, Health and Medicine. 2nd edition Cambridge University Press.

Incident reporting in one UK accident and emergency department
Tighe, C.M., Woloshynowych, M., Brown, R., Wears, B. and Vincent, C. 2006. Incident reporting in one UK accident and emergency department. Accident and Emergency Nursing. 14 (1), pp. 27-37. https://doi.org/10.1016/j.aaen.2005.10.001

Techniques used in the investigation and analysis of critical incidents in healthcare
Rogers, S, Taylor-Adams, S. and Woloshynowych, M. 2006. Techniques used in the investigation and analysis of critical incidents in healthcare. in: Walshe, K. and Boaden, R. (ed.) Patient Safety: Research into Practice Maidenhead, UK Open University Press. pp. 130-143

The investigation and analysis of critical incidents and adverse events in healthcare
Woloshynowych, M., Rogers, S., Taylor-Adams, S. and Vincent, C. 2005. The investigation and analysis of critical incidents and adverse events in healthcare. Health Technology Assessment. 9 (19). https://doi.org/10.3310/hta9190

Error Reduction in Medicine: Final report to the Nuffield Trust
Lyons, M., Woloshynowych, M., Adams, S. and Vincent, C. 2004. Error Reduction in Medicine: Final report to the Nuffield Trust. Nuffield Trust.

Retrospective case record review: a blunt instrument that needs sharpening
Neale, G. and Woloshynowych, M. 2003. Retrospective case record review: a blunt instrument that needs sharpening. BMJ Quality and Safety. 12 (1), pp. 2-3. https://doi.org/10.1136/qhc.12.1.2

Exploring the causes of adverse events in British NHS hospital practice.
Neale, G., Woloshynowych, M. and Vincent, C. 2001. Exploring the causes of adverse events in British NHS hospital practice. Journal of the Royal Society of Medicine. 94, pp. 322-220. https://doi.org/10.1177/014107680109400702

Adverse events in British hospitals: preliminary retrospective record review
Vincent, C., Neale, G. and Woloshynowych, M. 2001. Adverse events in British hospitals: preliminary retrospective record review. BMJ. 322, pp. 517-519. https://doi.org/10.1136/bmj.322.7285.517

Immediate Recovery of Psychomotor Function After Patient-Administered Nitrous Oxide/Oxygen Inhalation for Colonoscopy
Trojan, J., Saunders, B.P., Woloshynowych, M., Debinsky, H.S. and Williams, C.B. 1997. Immediate Recovery of Psychomotor Function After Patient-Administered Nitrous Oxide/Oxygen Inhalation for Colonoscopy. Endoscopy. 29 (1), pp. 17-22. https://doi.org/10.1055/s-2007-1004055

The Patient Requests Form: a way of measuring what patients want from their general practitioner.
Valori, R., Woloshynowych, M., Bellenger, N., Aluvihare, V. and Salmon, P. 1996. The Patient Requests Form: a way of measuring what patients want from their general practitioner. Journal of Psychosomatic Research. 40 (1), pp. 87-94. https://doi.org/10.1016/0022-3999(95)00548-X

The measurement of beliefs about physical symptoms in English general practice patients
Salmon, P., Woloshynowych, M. and Valori, R. 1996. The measurement of beliefs about physical symptoms in English general practice patients. Social Science & Medicine. 42 (11), pp. 1561-1567. https://doi.org/10.1016/0277-9536(95)00263-4

Psychological aspects of gastrointestinal endoscopy: a review
Woloshynowych, M., Oakley, D.A., Saunders, B.P. and Williams, C.B. 1996. Psychological aspects of gastrointestinal endoscopy: a review. Endoscopy. 28 (9), pp. 763-767. https://doi.org/10.1055/s-2007-1005602

Permalink - https://westminsterresearch.westminster.ac.uk/item/v3214/the-effects-of-stress-on-surgical-performance


Share this

Usage statistics

155 total views
0 total downloads
These values cover views and downloads from WestminsterResearch and are for the period from September 2nd 2018, when this repository was created.