What lies beneath? Determining the personality of advanced laparoscopic surgeons: can a difference impact the quality of training?

Susannah M Wyles, MD, Anam Parand, MSc, Melody Ni, PhD, John T Jenkins, FRCS, George B Hanna, PhD, FRCS

Imperial College London, St Mark’s Hospital Harrow

Introduction There is increased pressure for trainees to choose their specialty early in their career and there has been previous discussion as to the possibility or acceptability of predetermining a doctor ‘type”, and pretesting trainees for their suitability for that particular branch of medicine or surgery. The aim of this study was to formerly assess the personality of trainers and trainees in laparoscopic colorectal surgery (LCS), to identify any differences in personality between surgeons and the normal population, and between “expert” surgeons (those performing LCS for >10 years) and “non-experts”, and determine whether any differences in personality are reflected in training outcomes.

Methods and procedures Two psychologists and one surgeon distributed a validated personality test (16PF) to LCS surgeons. Training sessions were assessed using the Global Assessment Score (GAS)1 form and mean values taken for each trainer. Statistical analyses: ANOVA, t test, Wilcoxon, Pearson correlation (p<0.05).

Results: 60 participants (36 trainers (of which 17 were experts), 24 trainees), aged 34-64, completed the 16PF. There were no significant differences found between any trainee and trainer surgeons, but they differed significantly from the normal population (Table). Experts were more “open to change” (E7.44 vs.N6.21, p=0.003), “open-minded” (E5.55 vs. N6.71, p=0.01)) and “willful” (E6.83 vs. N5.80, p=0.004) than non-experts. High GAS scores correlated significantly with “warmth” (r=.332, p=0.048).

Conclusion: Two-thirds of LCS surgeons’ personality factors differed significantly from the normal population. Experts were shown to be more open to change – perhaps why they became LCS pioneers? Trainers more attentive to their trainees’ produced higher GAS scores demonstrating that trainer warmth is positively correlated with the quality of trainees’ performance in laparoscopic colorectal surgery. Further work should assess associations between personality traits and clinical outcomes.

Reference:
1. Development, validation and implementation of a monitoring tool for training in laparoscopic colorectal surgery in the English National Training Program. Miskovic D, Wyles SM, Carter F, Coleman MG, Hanna GB. Surg Endosc. 2011;25(4):1136-42

	Surgeons (n=60) vs. normal population (WILCOXON)			Experts (n=17) vs. non-experts (n=43) (ANOVA)
Item	Median	Norm (5.5)	p	F (1,58)=	p
Warmth	5.00	Below	<0.001	0.960	0.331
Reasoning	8.00	Above	<0.001	0.029	0.866
Emotional Stability	7.00	Above	<0.001	0.287	0.594
Dominance	6.00	Above	0.002	0.567	0.455
Liveliness	5.50	Level	0.510	0.193	0.662
Rule- consciousness	5.00	Below	0.222	0.691	0.409
Social boldness	6.00	Above	0.095	0.571	0.453
Sensitivity	4.00	Below	<0.001	0.819	0.369
Vigilance	4.00	Below	<0.001	0.388	0.536
Abstractedness	5.00	Below	0.001	1.725	0.194
Privateness	5.00	Below	0.004	0.025	0.874
Apprehension	5.00	Below	0.003	0.000	0.988
Openness to change	5.00	Below	<0.001	9.411	0.003
Self reliance	5.00	Below	0.017	0.403	0.528
Perfectionism	5.00	Below	0.087	0.599	0.442
Tension	5.50	Level	0.737	2.614	0.111
Extraversion	6.00	Above	0.374	0.049	0.825
Independence	6.00	Above	0.001	8.807	0.004
Tough minded	6.00	Above	<0.001	7.058	0.010
Self-control	5.00	Below	0.807	1.130	0.292
Anxiety	5.00	Below	0.001	0.564	0.456
Response style				0.002	0.965