title: Managing intraoperative stress: what do surgeons want from a crisis training program?
abstract: BACKGROUND
  Current surgical training provides little opportunity for surgeons to recognize and manage intraoperative stress before it affects performance and compromises patient safety. We explored the perceived need for structured stress training and propose an intervention design that may be acceptable and appropriate.
  
  
  METHODS
  Fifteen semistructured interviews identified stressors in the operating room, characterized coping strategies, and explored surgeons' views about a training intervention. Interviews were analyzed using standard qualitative methods.
  
  
  RESULTS
  Stressors and coping strategies confirmed those identified in previous work. Key components of an intervention should include recognizing stress in oneself and in others; experiencing the impact of stress on performance; providing effective coping strategies; offering feedback; and providing opportunities to practice what has been taught in a safe, simulation-based environment.
  
  
  CONCLUSIONS
  There is a need for structured training in management of intraoperative stress. Surgeons would welcome a simulation-based intervention to enhance performance and patient safety.
authors.affiliation: Imperial College, London, England, UK. sonal.arora06@imperial.ac.uk
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.forename: Debra
authors.initials: D
authors.lastname: Nestel
authors.forename: Tanya
authors.initials: T
authors.lastname: Tierney
authors.forename: Maria
authors.initials: M
authors.lastname: Woloshynowych
authors.forename: Roger
authors.initials: R
authors.lastname: Kneebone
mesh_terms: D000223:Adaptation, Psychological; D002983:Clinical Competence; D003657:Decision Making; D004502:Education, Medical, Continuing; D013502:General Surgery; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D009873:Operating Rooms; D018794:Problem-Based Learning; D013315:Stress, Psychological; D013514:Surgical Procedures, Operative / Q000523:psychology*; D013647:Task Performance and Analysis