Exploring variation in surgical practice: does the surgeon's personality influence anastomotic decision-making?'

Carly N. Bisset* (Corresponding Author), Eamonn Ferguson, Ewan Macdermid, N. Yassin, Nicola Dames, Debby Keller, Raymond Oliphant, Simon Parson, Jen Cleland, Susan J Moug, Sharon Stein , Plato Project Steering Group Collaborators

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Decision-making under uncertainty may be influenced by the individual’s personality. The primary aim was to explore associations between surgeon personality traits and colorectal anastomotic decision-making.
Methods: Colorectal surgeons worldwide participated in a two-part online survey. Part 1 evaluated surgeon characteristics using the Big Five Inventory to measure personality (five domains: agreeableness; conscientiousness; extraversion; emotional stability; openness) in response to scenarios presented in Part 2 involving anastomotic decisions (i.e., rejoining the bowel with/without temporary stomas, or permanent diversion with end colostomy).
Anastomotic decisions were compared using repeated measure ANOVAs. Mean scores of traits domains were compared with normative data using 2-tailed t-tests.
Results: 186 surgeons participated, with 127 surgeons completing both parts of the survey (68.3%). Most surgeons were male (n = 131, 70.4%) and Europe-based (n = 144, 77.4%). 41.4% began independent practice within the last five years (n = 77). Surgeon personality differed from the general population, with significantly higher levels of
emotional stability (3.25 vs 2.97 respectively), lower levels of agreeableness (3.03 vs 3.74), extraversion (2.81 vs 3.38) and openness (3.19 vs 3.67) and similar levels of conscientiousness (3.42 vs 3.40 (all p <0.001)). Female surgeons had significantly lower levels of openness (p<0.001) than males (3.06 vs 3.25). Personality was associated with anastomotic decision making in specific scenarios.
Conclusions: Colorectal surgeons have different personality traits from the general population. Certain traits seem to be associated with anastomotic decision-making but only in specific scenarios. Further exploration of the association of personality, risk-taking and decision-making in surgery is necessary.
Original languageEnglish
Pages (from-to)1156-1163
Number of pages8
JournalBritish Journal of Surgery
Issue number11
Early online date19 Jul 2022
Publication statusPublished - Nov 2022
EventTripartite Colorectal Meeting : Looking Forward, Looking After – Mā Muri Ki Mua - Auckland, New Zealand
Duration: 22 Feb 202224 Feb 2022

Bibliographical note

This work was kindly supported by Bowel Research UK and the Ileostomy and Internal Pouch Association. The funders had no influence in the design, delivery, or interpretation of this study.

The study authors are grateful to all participants who took part, as well as those individuals and professional bodies who shared the Plato Project survey, including: the Association of Coloproctology of Great Britain and Ireland, the COVIDSurg Collaborative Group, the Turkish Society of Colon and Rectal Surgery and the Italian Surgical Research Group.

Data Availability Statement

Supplementary material
Supplementary material is available at BJS online.


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