title: Tolerance of uncertainty, extroversion, neuroticism and attitudes to randomized controlled trials among surgeons and physicians.
abstract: BACKGROUND
  Surgeons have a reputation for decisiveness and self-confidence, which suggests that they may tolerate uncertainty poorly and therefore be less capable than other doctors of experiencing clinical equipoise. Their 'typical' behaviour is characteristic of the stable extrovert personality and so they may prefer spontaneous clinical judgement over randomized trials. The aim of this study was to compare personality dimensions and tolerance of uncertainty among surgeons and hospital physicians, to determine whether differences in either property might help to explain the apparently poor performance of surgeons in conducting randomized controlled trials.
  
  
  METHODS
  This was a postal questionnaire study of 1000 consultant general surgeons and 1000 consultant physicians. Respondents completed a short self-assessment of Eysenck personality dimensions, Budner's Intolerance of Ambiguity scale and a short questionnaire about attitudes to randomized trials. Correlation and multiple regression analyses were performed.
  
  
  RESULTS
  The response rate was 36.5 per cent. Physicians were more likely to be women (P < 0.001) and had spent 1 more year in academic posts than surgeons (P < 0.030). Surgeons were significantly more extrovert (P < 0.001) and less neurotic (P < 0.001) than physicians. Surgeons were significantly more intolerant of uncertainty than physicians (P = 0.007). Multivariate analysis identified age (P < 0.030) and sex (P = 0.015) as independent predictors of intolerance of uncertainty. The attitudes of surgeons and physicians to randomized trials were no different.
  
  
  CONCLUSIONS
  Surgeons are not prejudiced against randomized trials, but their intolerance of uncertainty may inhibit them from deciding that an individual patient is suitable for trial entry. If more surgeons were female, this difference between surgeons and physicians might disappear.
authors.affiliation: Academic Unit of Surgery, University of Liverpool, Liverpool, UK. peter.mcculloch@nds.ox.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: McCulloch
authors.forename: A
authors.initials: A
authors.lastname: Kaul
authors.forename: G F
authors.initials: GF
authors.lastname: Wagstaff
authors.forename: J
authors.initials: J
authors.lastname: Wheatcroft
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D011287:Prejudice; D011594:Psychometrics; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires