Bournemouth 2017

Impact of personality and situation on decision-making about anastomosis and diversion – an interview with Susan Moug

At this year’s ACPGBI annual meeting in Bournemouth, 3-5 July, Ms Susan Moug (Consultant Colorectal and General Surgeon at NHS Greater Glasgow and Clyde, UK) will present the final results of a study that looked at personality and situational factors influencing surgical decision-making around stoma formation after anterior resection for rectal cancer.

At last year’s meeting in Edinburgh, 50 attendees that are all independent operators and decision makers (consultant surgeons, ST7/8, post-CCT fellows), age etc., were invited via the ACPGBI’s social media to complete 3 questionnaires (to assess their personality types). They were then asked to run through some clinical scenarios to determine their heuristics (decision-making) processes. The preliminary results of the study, funded by BDRF, were then presented to attendees in the afternoon.

“In Bournemouth, we will be presenting the final results and we will discuss the personality type of the participants – anonymously of course – and then try and link their questionnaire results to clinical scenarios,” she explained. “Ultimately, we are trying to determine whether surgeons with certain personality traits opt for a particular type of procedure, as well as provide surgeons with an insight into their personality type and why they make particular decisions. All surgeons consider a patient’s risk factors, disease type and severity etc prior to surgery. However, this study is attempting to show is that there is a third construct, which leads surgeons to make certain decisions despite the fact we all received very similar training.”

She added that traditionally there are certain stereotypes of surgeons – male, older, autonomous with their decision rarely being challenged. However, a lot has changed in the last 15-20 years and the traditional view of surgeons is changing.

With the help of a psychologist, the researchers developed three different questionnaires and tests to ascertain a) their personality type (eg. extrovert, introvert), b) whether they have an inability to express emotion or to understand others’ emotions (Alexithymia), and c) a cognitive reflections test – an intelligence test that shows how participants process e.g. quick gut reaction or more thought out.

For example, three surgeons presented with the same patients could decide to perform three different procedures: anastomosis without diversion, anastomosis with diversion (loop ileostomy) or no anastomosis (end colostomy),” explained Ms Moug. “We believe the difference in their decision-making is linked to their personality traits.”

A psychologist has compared the results with other social groups and in Bournemouth the researchers will reveal whether surgeons’ personalities fit the previously stated stereotypes.

“There are only a couple of similar studies in published literature. These studies revealed if a surgeon is younger (under 50 years old) and not a ‘risk-taker’ outside of surgery, they are more likely to make a stoma. In contrast, older surgeons were less likely to make a stoma even though classically, we tend to become more risk averse with age.  She added, “There is clear need to improve the understanding of surgeons’ rational and irrational factors that influence their decision-making. This is a unique, UK-based study, that will describe the type of surgical personalities in current practice and attendees will been given some insights into their personalities and the personalities of their colleagues, and we look forward to presenting the outcomes in July.”

To find out more about this study, please click here.