title: What stress coping strategies are surgeons relying upon during surgery?
abstract: BACKGROUND
  The objective of this study was to determine sources of intraoperative stress, impact on surgical outcomes, coping strategies, and surgeon interest in stress management training.
  
  
  METHODS
  An anonymous survey was electronically distributed to surgeons at a tertiary care hospital. Respondents were asked to rate the perceived impact of 9 stressors on operative performance, identify stress coping strategies, list witnessed stress-related complications, and opine on the perceived need for stress management training.
  
  
  RESULTS
  Seventy-two responses were received (76% relative risk). Complex or rarely performed cases and poor assistance were associated with the highest stress, while personal life distractions were associated with the least. Importantly, 40% of surgeons indicated that they had witnessed an intraoperative complication directly related to surgeon stress. Respondents (82%) believed that formal stress management training is needed.
  
  
  CONCLUSIONS
  Several stressors affect surgical performance and contribute to complications. Surgeons use a variety of stress coping strategies. Formal stress management training is needed.
authors.affiliation: Carolinas Simulation Center, Carolinas HealthCare System, 1200 Blythe Boulevard, Charlotte, NC 28203, USA.
authors.forename: Nicholas E
authors.initials: NE
authors.lastname: Anton
authors.affiliation: Department of Surgery, University of Colorado, Aurora, CO, USA.
authors.forename: Paul N
authors.initials: PN
authors.lastname: Montero
authors.affiliation: Carolinas Simulation Center, Carolinas HealthCare System, 1200 Blythe Boulevard, Charlotte, NC 28203, USA.
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Howley
authors.affiliation: Get Your Head In The Game, Inc, Charlotte, NC, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Brown
authors.affiliation: Carolinas Simulation Center, Carolinas HealthCare System, 1200 Blythe Boulevard, Charlotte, NC 28203, USA; Department of Surgery, Carolinas HealthCare System, Charlotte, NC, USA. Electronic address: dimitrios.stefanidis@carolinashealthcare.org.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Stefanidis
mesh_terms: D000223:Adaptation, Psychological; D002983:Clinical Competence; D006801:Humans; D007396:Internship and Residency; D007398:Interpersonal Relations; D007431:Intraoperative Complications / Q000523:psychology; D009657:North Carolina; D013315:Stress, Psychological / Q000209:etiology / Q000517:prevention & control*; D066231:Surgeons / Q000523:psychology*; D013514:Surgical Procedures, Operative / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Performance enhancement; Stress; Stress management training; Surgeons