508 Preparing Physicians For Failures: A Needs Assessment

Abstract

INTRODUCTION: Although anecdotal evidence points to high levels of stress among neurosurgeons and trainees, there is little systematic research documenting the nature of stress in detail. METHODS: We conducted a detailed survey of neurosurgeons and trainees, obtaining 22/26 responses (85% response rate) with 2 responses removed for missingness. Participants were purposefully sampled from two academic center neurosurgery programs. RESULTS: Participants reported more high-arousal negative emotions (particularly frustration and anxiety) than low-arousal negative emotions (e.g., helplessness, discouragement), suggesting relatively high levels of motivation. Within training levels, sources of stress varied considerably, suggesting the need for tailored approaches to stress management. Attendings reported quite a lot of stress from patient expectations and administrative constraints, whereas trainees focused more on teamwork and difficult patients. A focus on processes and specific mechanisms of problems at work was associated with more high-arousal emotions, whereas a focus on outcomes was associated with low-arousal emotions; this pattern is consistent with prior research on other populations. As expected, residents were most likely to use coping strategies that reflected a lack of control over one’s schedule (e.g., immersing oneself in work) whereas attendings were most likely to use healthy strategies, particularly physical exercise. Only one of the 20 participants reported seeking professional support due to stress; residents were most likely to attribute this to a lack of time or resources but most participants did not feel a need to seek professional help. Attendings were least likely to report ideas for what education or training they could have benefited from to better cope with stress. CONCLUSIONS: This work points to key ways dealing with failure and stress contributes to individual well-being as well as neurosurgical culture.