What We Talk About When We Talk About Coping: A Qualitative Study of Surgery Resident's Coping After Complications and Deaths

Abstract

Objective: To explore how surgery residents cope with unwanted patient outcomes including postoperative complications and death.

Background: Surgery residents face a variety of work-related stressors that require them to engage in coping strategies. Postoperative complications and deaths are common sources of such stressors. Although few studies examine the response to these events and their impacts on subsequent decision-making, there has been little scholarly work exploring coping strategies among surgery residents specifically.

Methods: This study investigated the ways, in which general surgery residents cope with unwanted patient outcomes, including complications and deaths. Mid-level and senior residents (n = 28) from 14 academic, community, and hybrid training programs across the United States participated in exploratory semistructured interviews conducted by an experienced anthropologist. Interview transcripts were analyzed iteratively, informed by thematic analysis.

Results: When discussing how they cope with complications and deaths, residents described both internal and external strategies. Internal strategies included a sense of inevitability, compartmentalization of emotions or experiences, thoughts of forgiveness, and beliefs surrounding resilience. External strategies included support from colleagues and mentors, commitment to change, and personal practices or rituals, such as exercise or psychotherapy.

Conclusions: In this novel qualitative study, general surgery residents described the coping strategies that they organically used after postoperative complications and deaths. To improve resident well-being, it is critical to first understand the natural coping processes. Such efforts will facilitate structuring future support systems to aid residents during these difficult periods.