When Bad Things Happen to Good Surgeons: Reactions to Adverse Events

Luu, Shelly; Leung, Shuk On Annie; Moulton, Carol‐Anne

doi:10.1016/j.suc.2011.12.002

Cited by 41 publications

(46 citation statements)

References 34 publications

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“…Similar concerns have been identified among surgeons. 48 Unfortunately, a large percentage of clinicians continue to work immediately after an adverse event. Gazoni found that only 7% of anesthesiologists were relieved after a major event.…”

Section: Impact Of Emotional State On Quality Of Carementioning

confidence: 99%

Care of the clinician after an adverse event

Pratt

Jachna

2015

International Journal of Obstetric Anesthesia

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Section: Impact Of Emotional State On Quality Of Carementioning

confidence: 99%

Care of the clinician after an adverse event

Pratt

Jachna

2015

International Journal of Obstetric Anesthesia

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“…[17][18][19][20][21] With its different research focus-around complexity-our study has also identified an emotional dimension, but has moved further by offering rich insights into three additional heretofore unexplored dimensions of complexity in surgical situations (team dynamics, trust, and external pressures). We suspect that these findings were possible because of the methodological innovation we implemented.…”

Section: Discussionmentioning

confidence: 99%

“…Context therefore becomes a fundamental construct for seeking to understand not only what makes a situation complex but also how people respond to it. Investigators studying expertise-in-context, for instance, have uncovered and articulated procedural factors that can lead to errors, 16 emotional and psychological reactions that result from adverse intraoperative events, [17][18][19][20][21] and contextual factors that influence internists' clinical reasoning. 22 This work has advanced the community's understanding of how experts respond to and make decisions under the influence of multiple competing contextual factors.…”

mentioning

confidence: 99%

What’s Behind the Scenes? Exploring the Unspoken Dimensions of Complex and Challenging Surgical Situations

et al. 2014

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Findings show that analysis of surgeons' drawings is an effective means of gaining insight into surgeons' perceptions. The findings refine the common belief that procedural complexity is what makes a surgery challenging for expert surgeons. Focusing exclusively on the procedure during training may put trainees at risk of missing the "big picture." Understanding the multidimensionality of medical challenges and having a language to discuss these both verbally and visually will facilitate teaching around challenging situations.

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“…Surgical decision‐making frequently involves complexity, uncertainty, time pressure and limited information. If a patient dies, surgeons may experience emotional reactions, including disappointment, sadness, rumination, perceptions of missed opportunities and possibly regret. Regret may be an unavoidable part of clinical practice and differs from the response to medical error because, even following the best decisions and actions, adverse outcomes occur.…”

Section: Introductionmentioning

confidence: 99%

Learning from regret

Boyle¹,

Allen

Rey-Conde

et al. 2020

British Journal of Surgery

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Background Death after surgery is infrequent but can be devastating for the surgeon. Surgeons may experience intense emotional reactions after a patient's death, reflecting on their part in the death and the patient's loss of life. Excessive rumination or feelings of regret may have lasting negative consequences, but these reactions may also facilitate learning for future decision‐making. This qualitative study analysed surgeons' reflections on what might have been done differently before a patient's death and explored non‐technical (cognitive and interpersonal) aspects of care as potential targets for improvement. Methods In Australia's Queensland Audit of Surgical Mortality, surgeons reflect on factors surrounding the death of patients in their care and respond to the open‐ended question: in retrospect, would you have done anything differently? Framework analysis was applied to surgeons' responses to identify themes relating to non‐technical aspects of care. Results Responses from 1214 surgeons were analysed. Two main themes were identified. Dilemmas and difficult decisions confirmed the uncertainty, complexity and situational pressures that often precede a surgical death; regret and empathy for patients featured in some responses. In the second main theme, communication matters, surgeons cited better communication, with patients, families, colleagues and at handover, as a source of reflective change to improve decision‐making and reduce regret. Conclusion Surgical decision‐making involves uncertainty, and regret may occur after a patient's death. Enhancing the quality of communication with patients and peers in comprehensive assessment of the surgical patient may mitigate postdecision regret among surgeons.

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When Bad Things Happen to Good Surgeons: Reactions to Adverse Events

Cited by 41 publications

References 34 publications

Care of the clinician after an adverse event

Care of the clinician after an adverse event

What’s Behind the Scenes? Exploring the Unspoken Dimensions of Complex and Challenging Surgical Situations

Learning from regret

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