2056 How Do Neurosurgeons Cope With Complications? Results of a Nationwide Survey

INTRODUCTION: Complications are an unfortunate, ubiquitous part of neurosurgery. METHODS: We surveyed 142 members of the Congress of Neurological Surgeons (CNS) to delineate the array of coping mechanisms adopted and the magnitude of impact that complications have on their wellbeing. RESULTS: Most respondents had complications that resulted in the death of a patient (58.5%) and even more had complications that resulted in short or long-term harm (80.3% and 79.6%, respectively). Complications had a significant (55.6%) or profound (38.0%) impact on emotional wellbeing. The most common healthy coping strategies were using errors as teaching opportunities (80.3%), speaking with a spouse/partner (65.5%), and exercise (61.9%). The most common unhealthy coping strategies were sleeping disturbances (64.9%), social withdrawal (47.4%), and overeating (31.6%). The most common adaptive and maladaptive defense mechanisms utilized were humor (65.0%) and intellectualization (80.2%), respectively. On subgroup analysis, junior neurosurgeons were more likely to utilize a greater number of both adaptive and maladaptive coping mechanisms than were senior neurosurgeons (parameter estimate (SE) = -0.31 (0.14), p = 0.01 and parameter estimate (SE) = -0.37 (0.14), p = 0.01, respectively). Academic neurosurgeons were more likely to question their clinical abilities than were private (OR 2.68, 95% CI 1.21 – 5.96). When assessing years of practice, type of practice, or gender, there was no difference in contemplation of leaving the field, clinical self-doubt, propensity to admit fault, or number and type of coping mechanisms. CONCLUSIONS: Complications have a major impact on the wellbeing of neurosurgeons, who use a variety of healthy and unhealthy mechanisms to cope with them. These findings underscore the importance of interventions that bolster the resilience of neurosurgeons in managing the emotional aftermath of complications.