COPING AND RESILIENCE AFTER ADVERSE SURGICAL EVENTS FOR ORTHOPAEDIC SURGEONS IN NEW ZEALAND

Background Adverse surgical events are an inherent risk in orthopaedics and can result in significant patient harm. The emotional toll on surgeons is increasingly recognised as a critical issue for clinician wellbeing and patient safety. Despite international awareness of this phenomenon, little is known about the emotional and professional impact of such events on orthopaedic surgeons in New Zealand. Methods A cross-sectional, vignette-based online survey was distributed to orthopaedic consultants and trainees across New Zealand. Participants were asked to respond to five emotionally complex clinical scenarios, designed to explore distinct themes and responsibilities of the clinician involved. Results A total of 153 surgeons participated. Emotional responses were consistently high across all vignettes, with guilt, professional self-doubt, anxiety, and sadness commonly reported. Intra-operative nerve injury was the most challenging scenario, the highest emotionally impactful score was associated with postoperative death. Surgeon preference for dealing with complications involved discussion with a colleague followed by personal reflection. Challenges regarding accessing formalised support are elaborated on below. Discussion Emotional impact was significant across surgeon experience levels. The severity of emotional distress did not always align with clinical outcomes, but more often reflected perceived personal responsibility and the preventability of the event. The most common initial response following a complication was to discuss the incident with a colleague. Personal reflection was ranked second highest—suggesting either a preference of these individuals for introspection or limited access to confidential support systems. Many participants also relied on external coping strategies including family and exercise. There was considerable reluctance to seek formal psychological support. A common concern with forums such as M&M meetings was fear of reputational damage and judgement from peers. Conclusion Confidential, peer-based support systems and resilience training are needed. A formalised mentoring framework with CPD-linked incentives may enhance uptake. These findings inform future wellbeing initiatives and help inform institutional culture change within surgical departments.