Dr. Carly Bisset

The Science of Decision-Making in Surgery: “Me-search Research”

This Surgical Open Classroom aims to introduce surgeons to non-technical skills and individual differences psychology, including: personality, decision-making and risk perception. When presented with the same patient information, no two surgeons would necessarily make the same clinical decision, irrespective of specific patient factors or surgeon experience. While shared decision-making with patients is considered the ‘gold standard’, few have sought to demonstrate how surgeon-specific non-technical factors may influence patient-surgeon interactions as well as peri-operative decision-making. Of particular interest is how complex information is communicated to patients, including the complex concept of risk, influencing how shared decisions are made. One possible factor accounting for individual differences in decision-making is the surgeon’s personality, as well as individual risk perception. There is increasing global interest in how introspection and cognitive testing may alert surgeons to cognitive bias (systematic errors of thought), heuristics (use of ‘rule of thumbs’), and the negative impact these may have upon the surgeon’s non-technical skillset. Within colorectal surgery, surgeon personality and risk perception has been found to be influential upon anastomotic decision-making and is undergoing further exploration. While it is well established that the patient’s personality is influential upon post-operative outcomes including quality of life metrics, the influence of the surgeon’s personality on patient outcomes is yet to be established.