Surgeons should be given 'emotional intelligence' training to combat burnout epidemic, expert says

SURGEONS should be given regular ‘emotional intelligence’ training as an ‘explicit’ part of their professional development - to combat epidemic levels of burnout in the profession.

That’s according to a leading UK psychologist, who argues the sessions are urgently needed to protect both surgeons and their patients.

Emotional intelligence is defined as someone’s ability to understand their own emotions, and those of the individuals they interact with.

Training sessions in emotional intelligence are commonly used in the business world to improve mental wellness but aren’t yet being fully utilized in the medical community.

And Dr Lorna Bourke, Principal Lecturer in Psychology at Liverpool Hope University, says this type of training could help to reduce the stigma associated with anyone who reaches out for emotional support.

Urgent action is needed to improve the workplace environment for surgeons, and doctors, and to ensure they are supported as well as possible. And Emotional Intelligence should be an explicit part of ongoing contemporary surgical training and education. These are committed, resilient, driven individuals who are being lost to the profession while at their peak. For a surgeon, a ‘bad day at the office’ would be a typical person’s worst nightmare. Yet they often regulate their emotions by putting up a barrier without processing it properly, which can create real problems. We need a system where surgeons are given regular Emotional Intelligence testing and training, and strategies put in place to help them - where they can really talk about what they’ve been through, without them feeling as if they need to mask it.”

Dr Lorna Bourke, Principal Lecturer in Psychology at Liverpool Hope University

Burnout among both surgeons and others in the medical professions continues to be a huge issue in England.

Last year the Royal College of Surgeons (RCS) issued a report highlighting the need for surgeons to be better equipped to recognize the early signs of deteriorating mental health.

The RCS said symptoms of burnout include ‘feeling emotionally drained, fatigued and frustrated at work, feeling unable to accomplish much and not enjoying working with patients anymore’, while adding: “Surgeons who are burnt out can begin to treat others as if they were impersonal objects, not really caring about colleagues or work, becoming callous and blaming others.”

A study in 2018, by the National Institute for Health Research (NIHR) School for Primary Care Research, described doctor burnout as an ‘epidemic’ that affects patient safety, quality of care and patient satisfaction.’

And in January this year the British Medical Association (BMA) warned a third of doctors were reporting burnout and ‘compassion fatigue’.

For Dr Bourke, twice-yearly Emotional Intelligence training sessions for surgeons could make a big difference.

Earlier this year she joined forces with two surgeons based in Australia - Gary Sharp, of the Institute of Academic Surgery, Sydney, and Matthew Rickard, of The University of Sydney - to co-author an academic review of the benefits of emotional intelligence in both the medical and business communities.

The study, published in the ‘ANZ Journal of Surgery’, concluded: “Higher Emotional Intelligence (EI) levels may reduce stress and burnout, improve leadership and improve patient trust.

“The surgical community as a whole must be mindful that those factors deemed to affect EI most; lack of sleep, long working hours, poor job satisfaction and interpersonal relationships, are those that surgeons face on a daily basis.

“As such, surgeons should be the first to enrol in EI continued professional development modules to reduce stress, increase positive emotions and improve patient care.”

While Dr Bourke recognizes that Emotional Intelligence is factored-in to medical degrees, it’s often forgotten about during ongoing professional development.

She reveals: “Emotional Intelligence needs to be an ongoing concern. You should become more skilled, more adaptive. It should be part of professional development, not just initial training.

“Emotional intelligence isn’t just a personality ‘trait’. Rather it’s a skill that you can nurture and develop - which is where training comes in.

“And it boils down to a recalibration of skills, rather than developing a brand new skill set.”

Emotional Intelligence is typically taught through role-playing scenarios, helping surgeons to identify subtle symptoms of burnout at the earliest stage possible.

While Dr Bourke acknowledges that surgeons may be reluctant to undergo this extra training, she adds: “We need to break the entrenched ways of doing things.

“The key is in striking a balance between something that’s non-threatening for the surgeon but which also doesn’t result in the surgeon feeling as if they’re wasting their time doing it.

“I think we need to be doing the sessions once or twice every year as part of this recalibration.

“And it needs to be treated like going to the dentist - normalized, where surgeons can check in, or request more sessions, if they think it would be beneficial.

“Crucially, Emotional Intelligence training doesn’t need to be expensive.

“It’s used widely in the business community and there are many online providers.

“Compared to the cost of training a surgeon or medic, it’s negligible.

“You have mental health practitioners in the hospital setting - but medics may be reluctant to access them because of the stigma associated with seeking help.

“Emotional Intelligence lessons are, instead, a way to start destigmatising the issue.”

Surgeon and study co-author Gary Sharp says Emotional Intelligence is also key to doctor-patient trust.

I personally feel that Emotional Intelligence is paramount to a patient doctor relationship which in turn ensures trust. Surgery is complicated and patients are scared, regardless of the "size" of the procedure. It's our job to notice these subtle tell-tale signs and act accordingly, without Emotional Intelligence this is impossible. Working excessive hours takes its toll. Realizing this, through EI, and becoming aware of one’s anxieties, fears, stresses allows me to find outlets to reduce these feelings. Since publishing the article I certainly have become more aware of EI. I can honestly say that it's helped me daily to come to terms with my feelings but also ensure I recognize what others are feeling and act accordingly. EI should be a part of all doctors training, not as a single course we "must" attend but as ongoing life enhancing programs.”

Gary Sharp, Institute of Academic Surgery, Australia