Trait Emotional Intelligence in Surgeons

Abstract

Trait emotional intelligence (trait EI or trait emotional self-efficacy) concerns people’s perceptions of their emotional functioning. Two studies investigated this construct in surgeons and comparison occupations. We hypothesized that trait EI profiles would differ both within surgical specialties as well as between them and other professions. Study 1 (N = 122) compared the trait EI profiles of four different surgical specialties (General, Orthopedic, Head and Neck, and Miscellaneous surgical specialties). There were no significant differences amongst these specialties or between consultant surgeons and trainees in these specialties. Accordingly, the surgical data were combined into a single target sample (N = 462) that was compared against samples of engineers, executives and senior managers, lawyers, junior military managers, nurses, and salespeople. Surgeons scored significantly higher on global trait EI than junior military managers, but lower than executives and senior managers, salespeople, and nurses. There were no significant differences vis-à-vis engineers or lawyers. A MANOVA confirmed a similar pattern of differences in the four trait EI factors (Wellbeing, Self-control, Sociability, and Emotionality). Global trait EI scores correlated strongly with single-question measures of job satisfaction (r = 0.47) and job performance (r = 0.46) in the surgical sample. These findings suggest that interventions to optimize the trait EI profiles of surgeons can be helpful in relation to job satisfaction, job performance, and overall psychological wellbeing.

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ORIGINAL RESEARCH
published: 10 March 2022
doi: 10.3389/fpsyg.2022.829084
Edited by:
Richard Eleftherios Boyatzis,
Case Western Reserve University,
United States
Reviewed by:
Ronald H. Humphrey,
Lancaster University, United Kingdom
Annamaria Di Fabio,
University of Florence, Italy
*Correspondence:
Nick Sevdalis
nick.sevdalis@kcl.ac.uk
†
†
†ORCID:
K. V. Petrides
orcid.org/0000-0002-7130-8673
Matheus F. Perazzo
orcid.org/0000-0003-1231-689X
Pablo A. Pérez-Díaz
orcid.org/0000-0001-8303-9530
Nick Sevdalis
orcid.org/0000-0001-7560-8924
‡These authors share senior
authorship
Specialty section:
This article was submitted to
Personality and Social Psychology,
a section of the journal
Frontiers in Psychology
Received: 04 December 2021
Accepted: 04 February 2022
Published: 10 March 2022
Citation:
Petrides KV, Perazzo MF,
Pérez-Díaz PA, Jeffrey S,
Richardson HC, Sevdalis N and
Ahmad N (2022) Trait Emotional
Intelligence in Surgeons.
Front. Psychol. 13:829084.
doi: 10.3389/fpsyg.2022.829084
Trait Emotional Intelligence in
Surgeons
K. V. Petrides1†, Matheus F. Perazzo2†, Pablo A. Pérez-Díaz3†, Steve Jeffrey4,
Helen C. Richardson5, Nick Sevdalis6*†‡ and Noweed Ahmad5‡
1London Psychometric Laboratory, University College London, London, United Kingdom, 2School of Dentistry, Federal
University of Goiás, Goiânia, Brazil, 3Institute of Psychology, Austral University of Chile, Puerto Montt, Chile, 4Steve Jeffrey
International FZE LLC, Dubai, United Arab Emirates, 5Department of Otolaryngology, James Cook University Hospital,
Cleveland, United Kingdom, 6Centre for Implementation Science, King’s College London, London, United Kingdom
Trait emotional intelligence (trait EI or trait emotional self-efficacy) concerns people’s
perceptions of their emotional functioning. Two studies investigated this construct in
surgeons and comparison occupations. We hypothesized that trait EI profiles would
differ both within surgical specialties as well as between them and other professions.
Study 1 (N=122) compared the trait EI profiles of four different surgical specialties
(General, Orthopedic, Head and Neck, and Miscellaneous surgical specialties). There
were no significant differences amongst these specialties or between consultant
surgeons and trainees in these specialties. Accordingly, the surgical data were combined
into a single target sample (N=462) that was compared against samples of
engineers, executives and senior managers, lawyers, junior military managers, nurses,
and salespeople. Surgeons scored significantly higher on global trait EI than junior
military managers, but lower than executives and senior managers, salespeople, and
nurses. There were no significant differences vis-à-vis engineers or lawyers. A MANOVA
confirmed a similar pattern of differences in the four trait EI factors (Wellbeing, Self-
control, Sociability, and Emotionality). Global trait EI scores correlated strongly with
single-question measures of job satisfaction (r=0.47) and job performance (r=0.46)
in the surgical sample. These findings suggest that interventions to optimize the trait EI
profiles of surgeons can be helpful in relation to job satisfaction, job performance, and
overall psychological wellbeing.
Keywords: clinical competencies, occupational profiling, personality, surgical training, military, TEIQue
INTRODUCTION
Trait emotional intelligence (trait EI) is defined as a constellation of emotional perceptions assessed
through questionnaires and rating scales (Petrides et al., 2007). Essentially, trait EI concerns people’s
perceptions of their emotional abilities, which is why it has also been labeled as “trait emotional
self-efficacy.” Table 1 presents the sampling domain of trait EI in adults.
There is an expanding body of evidence (many hundreds of studies), including behavioral
genetic investigations (van der Linden et al., 2017, 2018;Alegre et al., 2019), giving reasons to
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Petrides et al. Emotional Profiling of Surgeons
conceptualize trait Emotional intelligence as part of human
personality. In addition, numerous studies have revealed
theoretically meaningful associations with important outcomes
like academic performance at university (Sanchez-Ruiz and El
Khoury, 2019), career decision-making (Farnia et al., 2018),
positive affect (Di Fabio and Kenny, 2019), body image (Pollatos
et al., 2020), and mental health (Petrides et al., 2017;Rudenstine
and Espinosa, 2018), among many others. Trait EI shows
incremental validity over the Giant Three (Psychoticism,
Extraversion, Neuroticism), the Big Five (Neuroticism,
Extraversion, Openness-to-Experience, Agreeableness, and
Conscientiousness), and multiple other personality variables
(Andrei et al., 2016;Stamatopoulou et al., 2016;Chirumbolo
et al., 2019). From these results, it is clear that the construct
captures emotion-related variation neglected by frameworks
such as the Big Five.
Because trait EI offers a comprehensive operationalization
of the affective aspects of personality, it provides the most
appropriate framework within which to investigate the general
emotional functioning of people, including, of course, physicians.
Moreover, trait EI correlates with many of the competencies
that modern medical curricula seek to deliver (Arora et al.,
2010;Andrei et al., 2016;Abe et al., 2018). Clinical ability in
healthcare practice is crucial for treatment success and career
prosperity, but incomplete without a trait EI basis (Lin et al., 2017;
Sharp et al., 2020). To investigate trait EI in a medical context
means to advance a holistic model that considers the inherent
psychological features of physicians as applied to their clinical
practice. It has been empirically shown that the trait EI profiles
of physicians and nursing personnel may predict or mediate
key outcomes in their professional life, such as job satisfaction
(Hollis et al., 2017), burnout (Szczygiel and Mikolajczak, 2018),
stress when undertaking surgical tasks (Arora et al., 2011;
O’Connor et al., 2017), malpractice claims (Shouhed et al., 2019),
and wellbeing (Lin et al., 2016). The burgeoning number of
EI applications in the medical literature attests strongly to its
importance in the field.
Gaps, however, remain. Most studies investigating trait EI
within a medical setting have focused on medical competences or
other professional outcomes for healthcare participants (Gupta
et al., 2017;Abe et al., 2018;Al Huseini et al., 2019). What
remains lacking is a systematic comparative analysis of trait
EI profiles of medical providers against those of non-medical
professionals. Such an analysis would be able to ascertain
whether the trait EI profiles within healthcare are similar or
dissimilar to those of professionals in other fields–hence pointing
to the generalizability of trait EI applications (e.g., training)
or, in contrast, to the need to tailor those specifically to the
medical context.
Accordingly, the present study contributes toward addressing
this gap in the evidence-base of trait EI within medicine. We
evaluated the trait EI profiles of the following surgical specialties:
General, Orthopedic, Head and Neck, and Miscellaneous
surgical specialties. Moreover, we compared the surgical data
against samples of distinct professions represented by engineers,
executives and senior managers, lawyers, military managers
(junior), nurses, and salespeople. We hypothesized that trait EI
profiles would differ both within surgical specialties as well as
between surgical specialties and other professions.
STUDY 1
Study 1 compared the trait EI profiles of different surgical
specialties using a leading multidimensional measurement
instrument (Bru-Luna et al., 2021). Previous research that has
looked at personality differences in healthcare samples has mostly
taken the form of prospectively conducted surveys at medical
schools (or equivalent), aimed at determining how personality
might affect future specialty selection (e.g., Mullola et al., 2018).
Moreover, cross-sectional studies across medical specialties have
compared the personality profiles of different subgroups of
specialized professionals against each other (e.g., Stienen et al.,
2018). Taken together, the findings of these studies have proved
hard to synthesize, and patterns of personality traits firmly
associated with “personality types” across different specialties
elusive to definitive descriptions.
We argue that one reason for this ongoing limitation in the
field is the plethora of personality assessment tools used across
studies based on theoretical approaches and psychometrics of
variable quality. We further argue that the field suffers from
a rather simplistic conception of a “personality type” across
medical specialties, which assumes larger homogeneity within
specialties than across them. Translated into a specific example,
this assumption means that pediatric surgeons are expected to
be “more like” orthopedic surgeons than pediatricians. This
assumption is rarely tested empirically.
Study 1 aimed to address these shortcomings in the literature
by directly measuring the trait EI of surgeons across several
different surgical specialties. Due to the variability in the
evidence on personality profiles of surgeons across different
specialties; the variability in the theories and assessment tools
applied; and the desirability of a combined surgical sample
for subsequent analyses, we considered this study a necessary
precursor to main Study 2.
MATERIALS AND METHODS
Participants
One hundred and twenty-two surgeons participated in the study.
The sample comprised 43 consultants (attending-level surgeons
in the United States), 63 registrars (senior residents), and 18 core
trainees (12 1st CT-year and 6 CT 2nd year; junior residents).
Gender and age information are reported in Table 2. The
following surgical specialties were represented in the sample:
cardiothoracic (n=5), general (n=25), neurosurgery (n=1),
ophthalmology (n=5), oral and maxillofacial (n=4), orthopedic
(n=36), otolaryngology (n=21), plastic (n=6), urology
(n=11), and vascular (n=4). Four surgeons listed their specialty
as “other.”
Following consultation with experienced academic surgeons,
four surgical groups were created: General (n=25), Orthopedic
(n=36), Head and Neck (comprising otolaryncology,
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TABLE 1 | The sampling domain of trait EI in adults.
Factors and Facets High scorers perceive themselves as. . .
Wellbeing
Self-esteem . . .successful and self-confident.
Trait happiness . . .cheerful and satisfied with their lives.
Trait optimism . . .confident and likely to “look on the bright side” of life.
Self-control
Emotion regulation . . .capable of controlling their emotions.
Stress management . . .capable of withstanding pressure and regulating
stress.
Impulse control . . .reflective and less likely to give into their urges.
Emotionality
Emotion perception . . .clear about their own and other people’s feelings.
Emotion expression . . .capable of communicating their feelings to others.
Relationships . . .capable of having fulfilling personal relationships.
Empathy . . .capable of taking someone else’s perspective.
Sociability
Social awareness . . .accomplished networkers with excellent social skills.
Emotion management . . .capable of influencing other people’s feelings.
Assertiveness . . .forthright, frank, and willing to stand up for their
rights.
Adaptability* . . .flexible and willing to adapt to new conditions.
Self-motivation* . . .driven and unlikely to give up in the face of adversity.
Global trait EI
*These facets are not keyed to any factor, but feed directly into the global trait
EI score.
ophthalmology, oral and maxilofacial, and neurosurgery;
n=31), and Miscellaneous (comprising cardiothoracic, vascular,
plastics, urology, and other; n=30) specialties.
Measure
Trait Emotional Intelligence Questionnaire
The TEIQue is a 153-item inventory providing comprehensive
coverage of the sampling domain of trait EI (Petrides, 2009).
The instrument has shown excellent psychometric properties
in multiple studies (Aluja et al., 2016;Andrei et al., 2016;
Chirumbolo et al., 2019;Sanchez-Ruiz et al., 2021). Items
are scored on a 7-point Likert scale and completion time is
approximately 30 min. The 20 TEIQue variables (15 facets, 4
factors, and global trait EI) are presented in Table 1, along with
TABLE 2 | Gender and age information for the seven comparison
samples in study 2.
Occupation Gender (M–F) Age
Engineers 27–3 40.28 (11.89)
Executives/senior managers 58–30 45.89 (7.18)
Lawyers 25–2 31.35 (6.59)
Military managers (junior) 61–6 29.43 (3.48)
Nurses 9–56 44.85 (8.58)
Salespeople 43–15 37.11 (9.15)
Surgeons 91–30 38.57 (8.90)
One surgeon and five military managers did not report their gender. Numbers in
parentheses are standard deviations.
brief explanations. All TEIQue instruments are available, free
of charge, for academic and medical research purposes from
www.psychometriclab.com.
Procedure
Higher specialist trainees and consultants from all surgical
specialties working in the former Northern Deanery region (now
Health Education North East) of the United Kingdom were
invited by email to take part in the study. Attached to the
invitation was an information sheet detailing the aims of the
study and the potential benefits and risks. This formed part of
the consent process. Anonymity and the right to withdraw at
any point without providing a reason were assured. The study
received full ethical approval from the Camden and Islington
Community Research Ethics Committee and was performed
with the facilitation of the Northern Deanery. As a reward
for their time, participants received a detailed personalized
TEIQue feedback report (valued at $60) immediately on
completion of the questionnaire, and were also entered into
a prize draw for a netbook or shopping voucher worth $375.
To improve recruitment, reminder emails were sent out on
three occasions.
Participants were categorized into groups following receipt of
their completed TEIQue forms. The grouping process aimed to
produce clusters of participants that were conceptually as well as
statistically viable. Grouping was led by an academic consultant
surgeon (HCR) and done jointly with another study author (NS)
based on consensus principles and with a view to achieving
balanced group sizes across the surgical specialties.
Participants were clustered into the four aforementioned
groups based on well-defined specialties (general and
orthopedic), consideration of the part of the body they
operate on (head and neck), and a final miscellaneous category
to include specialties that could not be grouped otherwise due to
small sample size (comprising cardiothoracic, vascular, plastics,
urology, and other; n=30).
RESULTS
A between-subjects analysis of variance with the four surgical
groups as levels of the independent variable and global trait EI
scores as the dependent variable was conducted. This returned
a non-significant result [F(3,118)=0.66, p=ns]. A MANOVA
at the factor level of trait EI (viz., with Wellbeing, Self-control,
Emotionality, and Sociability as the DVs) was similarly non-
significant [F(12,304 .55)=1.20, p=ns]. Corresponding analyses
comparing trainee vs. consultant surgeons also returned non-
significant results [ANOVA F(1,120)=2.68, p=ns: and
MANOVA F(4,117)=1.55, p=ns].
DISCUSSION
This study revealed strong homogeneity in the trait EI profiles
of surgeons. There were no differences between the groups,
which spanned a range of surgical specialties, or between trainee
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(junior) and consultant (senior) surgeons. The latter finding
is especially notable because of a potentially sizeable age gap
between trainees and consultants, which might have expected to
produce at least some differences in their profiles due to a small-
to-moderate correlation between trait EI and age (Siegling et al.,
2017;Aslanidou et al., 2018). No such differences were observed
at either the global or the factor level of the construct.
Since the data are not longitudinal, we cannot be certain
whether this homogeneity is the result of similarities at the
entry point of surgical training or of a homogenization process
operating during the course of training. Are the personalities
of surgeons similar at the entry point of surgical training or
do they gradually become similar as a result of training? In
the absence of longitudinal data, it is worth highlighting that
surgeons not only have their own reasons for entering surgical
training, which differ from the reasons other medical doctors
have for entering their own specialties, but that they are keenly
aware of these reasons (Peel et al., 2018). Given that career choice
is underpinned by clear-cut differences in personality (Farnia
et al., 2018;Xin et al., 2020), it seems more likely that trainee
surgeons have fairly homogeneous personalities upon entering
medical training. This is further supported by the fact that there
were no significant differences between trainee surgeons and
consultants despite a potentially sizeable age difference between
these two groups.
Although there is wide variation in perceptions of desirability
and suitability of different medical careers, the personality
characteristics of individuals within each medical specialty may
be highly homogenous (McKinley et al., 2015). This seems
to be the case as regards the affective aspects of the surgical
specialty. Obviously, these findings cannot be automatically
generalized to medical specialties other than those included
in our research. Nevertheless, they are sufficiently robust to
provide a ground for combining the present surgical data into
a large group with a view to comparing it against pertinent
professional groups.
STUDY 2
Study 2 compared the trait EI profiles of surgeons against the
profiles of professionals from a range of related (e.g., nurses) or
socially comparable occupations (viz., occupations with similarly
high social status, like lawyers and military managers). To
our knowledge, this is the first such comparison in the field
of emotional intelligence, and one of the more wide-ranging
in the broader field of personality. Some relevant trait EI
work was previously conducted by Siegling et al. (2014), who
compared a sample of United Kingdom managers against the
general population, Pérez-Díaz et al. (2021), who compared
various public and private sector occupations, and Dugger
et al. (2022), who compared a sample of U.S. pilots against
the general population. None of these works involved any
surgical specialties.
Other broadly relevant work presented a comparative analysis
of the personality of surgeons based on a large sample obtained
from an online personality assessment carried out by the
BBC (Whitaker, 2018). Significant differences were reported
between surgeons and non-surgeons on a Big Five tool, with
the former scoring higher on conscientiousness, agreeableness,
openness, and neuroticism. A limitation of that study was
that the comparison sample was largely undifferentiated,
when a comparison of surgeons against other professional
groups could well carry specific implications for training
and development.
Training approaches and modalities developed for high-
risk industries, such as aviation or the military, have often
been imported by surgical curricula without much adaptation
or assessment of training needs and requirements, largely
on the assumption that risk management and related skills
are automatically transferrable across areas of professional
activity (Kapur et al., 2016). Recently, such wholesale
imports into surgery have been questioned and a more
nuanced approach to surgical training has been called for
(Gogalniceanu et al., 2021). Broader comparisons with
socially comparable occupational groups, such as those
included in this study, could provide support for such a
nuanced approach.
Furthermore, differentiation between surgeons and other
health professions, such as nurses, in terms of emotional
predispositions and responsiveness can help tailor staff support
and wellbeing programs that have rapidly proliferated since
the advent of the COVID19 pandemic (e.g., Krausova et al.,
2021). While such programs are a welcome addition to
organizational staff support structures (and in many cases were
needed even pre-pandemic; Laurino Neto and Herbella, 2019),
tailoring them to professional groups’ needs can help increase
perceived relevance and hence their uptake and effectiveness in
supporting staff exposed to the stressors and pressures of the
pandemic, and beyond.
Trait emotional intelligence is a strong predictor of job
satisfaction, with effects that often persist over and above the
Big Five and cognitive ability (Miao et al., 2017). It has also
been found that leader trait EI relates positively to subordinate
job satisfaction (Miao et al., 2016). Similarly, the construct has
shown strong predictive ability in relation to job performance,
again, over and above the Big Five and cognitive ability (e.g.,
O’Boyle et al., 2011). An ancillary aim of our study was to
provide a first approximation of these effects in the domain
of surgery.
Materials and Methods
Participants
The surgeon sample described in Study 1 formed the focal
(target) group in this study. As such, it was also the largest
(n=122). It was compared against 72 junior military managers,
30 engineers, 88 executives and senior managers in various roles
(e.g., corporate management, human resources, and management
consultants), 58 salespeople from various industries (e.g., retail,
recruitment, and IT), 27 lawyers, and 65 nurses from a broad
range of specialties and roles (e.g., junior and senior sisters,
midwives, and directors of nursing departments). All groups were
sufficiently large to enable parametric comparisons as per the
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central limit theorem. Gender and age details about these groups
are given in Table 2.
Measures
Trait Emotional Intelligence Questionnaire
As described in Study 1.
Job Satisfaction and Job Performance
Responses to single-item measures of job satisfaction and
perceived job performance were available for all groups, except
lawyers. These questions were answered on 7-point Likert scales
and their exact phrasing was “How happy in your job are you?”
and “How good are you at your line of work?”
Procedure
The collection process of the surgical data was described
in Study 1. Military data were collected from the Army
Training Regiment in Winchester (England) from Corporals,
Sergeants, and Officers. Additional data were retrieved from
the TEIQue archives. All questionnaires were completed
individually and voluntarily. Completion took approximately
30 min.
RESULTS
Occupational Differences in Trait
Emotional Intelligence
A between-subjects analysis of variance with the seven
occupational groups as levels of the independent variable and
global trait EI scores as the dependent variable was performed.
There was a significant main effect of occupational group
[F(6,50)=19.38, p<0.01, η2=0.21]. This was followed through
with a series of Dunnett’s post-hoc tests with surgeons set as the
comparison (target) group. These comparisons, whose details are
presented in Table 3, showed that surgeons scored significantly
higher on global trait EI than junior military managers, but lower
than executives and senior managers, salespeople, and nurses.
There were no significant differences in the comparisons against
engineers and lawyers.
To investigate these data at the factor level of trait EI, a
MANOVA was conducted with the seven occupational groups as
TABLE 3 | Comparisons (Dunnett t-tests) between surgeons and six
professional groups.
N Mean Difference Std. Error
Engineers 30 0.031 0.112
Executives/Senior managers 88 0.502* 0.076
Lawyers 27 0.016 0.116
Military managers (junior) 72 −0.278* 0.083
Nurses 65 0.289* 0.084
Salespeople 58 0.499* 0.087
Dunnett t-tests treat one group as a control (Surgeons; n =122) against which all
other groups are compared. Comparisons are based on a 7-point Likert scale.
*p <0.01.
levels of the independent variable, and the four trait EI factors
(Wellbeing, Self-control, Emotionality, and Sociability) as the
dependent variables. There was a significant multivariate main
effect of occupational group, F(24,1560 .61)=6.66, p<0.001,
ηp2=0.08. Follow-up ANOVAs revealed highly significant
differences on all four trait EI factors: Wellbeing, F(6,450)=10.13,
p<0.001, ηp2=0.12; Self-control, F(6,450)=10.13, p<0.001,
ηp2=0.16; Sociability, F(6,450)=10.76, p<0.001, ηp2=0.13;
and Emotionality, F(6,450)=15.70, p<0.001, ηp2=0.13.
Dunnett’s post-hoc tests indicated that surgeons scored
significantly higher (p<0.01) than junior military managers on
Wellbeing and Self-control. Conversely, they scored significantly
lower than executives and senior managers on all four trait
EI factors (p<0.01), lower than salespeople on Self-control,
Emotionality, Sociability (p<0.01), and marginally lower
(p=0.05) on Wellbeing. Surgeons also scored lower than nurses
on Emotionality (p<0.01).
Correlations With Criteria
As an indicator of the impact of trait EI on job satisfaction
and job performance, we estimated within-group correlations.
Very interestingly, the correlations of global trait EI with job
satisfaction and job performance were highest for surgeons
(rjobsat =0.467 and rjobper =0.457) and second-highest for nurses
(rjobsat =0.417 and rjobper =0.448).
All four trait EI factors (Wellbeing, Self-control, Emotionality,
and Sociability) predicted both job satisfaction and job
performance. The strongest correlations at the factor level were
for Wellbeing and Sociability. The full correlation matrix is
depicted in Table 4.
DISCUSSION
The analyses revealed sharp trait EI profile differences
between surgeons and several other professional groups.
There were no differences vis-a-vis lawyers and engineers,
however, surgeons scored significantly higher on global
trait EI than junior military managers, and lower than
executives and senior managers, salespeople, and nurses.
These differences were broadly reflected across the four trait EI
factors too.
TABLE 4 | Correlations between Trait EI (Global and Factor Scores), job
satisfaction, and job performance in surgeons.
1 2 3 4 5 6 7
1. Wellbeing – 0.46* 0.48* 0.61* 0.81* 0.56* 0.42*
2. Self-control – 0.38* 0.41* 0.70* 0.29* 0.35*
3. Emotionality – 0.56* 0.81* 0.27* 0.27*
4. Sociability – 0.79* 0.31* 0.44*
5. Global trait EI – 0.47* 0.46*
6. Job satisfaction – 0.39*
7. Job performance –
*p <0.01.
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With respect to junior military managers, it should be noted
that some of the relevant variance may be confounded by age.
The literature suggests that trait EI increases, at least moderately,
with age (Tsaousis and Kazi, 2013;Pérez-Díaz et al., 2021), and so
the nine-year gap between surgeons and junior military managers
(the largest in the dataset; see Table 2) could partially explain
the difference in trait EI means. Nevertheless, these differences
generally persisted, albeit slightly diminished, in ANCOVAs
covarying out age. Therefore with some caution, because the
age correction does not also correct for the fact that military
managers were drawn from the junior levels of the army, we
can conclude that surgeons have significantly higher trait EI
scores. This finding probably reflects the necessity in military
settings of keeping the emotional aspects of personality in check.
It echoes findings based on airline pilots, whose training and
organizational cultures share many similarities with those of
military managers (Dugger et al., 2022).
Executives and senior managers, salespeople, and nurses,
all scored higher than surgeons on global trait EI, and in
most comparisons, on the four trait EI factors too. From the
perspective of surgeons, the key question is whether relatively
lower levels of trait EI are conducive to their work life. There
is a salient interpersonal aspect affecting both the teamworking
skills that surgeons need to show while in the operating
theater (Tørring et al., 2019) as well as their interactions with
patients and their families (Hsu et al., 2019). “Soft” skills in
surgeons, which are mirrored across multiple trait EI facets, may
contribute to enhanced patient care and improved relationships
with colleagues and staff (Sharp et al., 2020). In addition,
other personality traits that are important in surgery, and more
broadly in medicine, such as emotion regulation and acute stress
management, are specifically linked to intrapersonal facets of trait
EI (Weilenmann et al., 2018;Grantcharov et al., 2019). Overall,
surgeons experience high levels of stress, burnout, and suicidal
ideation (Shanafelt, 2011;Dimou et al., 2016), which is why trait
EI training can play a central role in improving their ability to
cope with pressure and prevent or ameliorate burnout (Lindeman
et al., 2017;Sharp et al., 2020).
Enhancements in the psychological wellbeing of surgeons will
likely be reflected in their patients’ satisfaction levels. Effective
healthcare is often measured in terms of patient satisfaction,
which is considered not just the element of care delivered
to patients, but also the way in which this was received
and experienced by the patients during the episode (Sharp
et al., 2020). It seems important to identify how, and under
what circumstances, trait EI may impact on major aspects
of care delivery and, subsequently, use this information to
amend existing interventions or develop new ones explicitly
tailored to surgeons. Trait EI-tailored interventions have shown
substantial and consequential score gains in experimental
research designs with university students (see Nelis et al.,
2009, 2011) as well as in naturalistic research in schools
(Ruttledge and Petrides, 2012;Li and Xu, 2019). Related
research has shown that other types of intervention, like Yoga
training, can also lead to score increases in trait EI measures
(McIlvain et al., 2015).
The applicability of trait EI in the work-life of surgeons is
on full display in the strong positive correlations between trait
EI scores and ratings of job satisfaction and job performance.
Undoubtedly, these results should be replicated with fully
validated measures of job satisfaction and job performance,
although it is worth noting that single-item measures may, under
certain circumstances, offer a viable psychometric alternative that
balances demands of brevity with those of reliability and validity.
Technically, single-item measures are prone to underestimate
the relationships between constructs (Credé et al., 2012), which
means that trait EI may be even more strongly related to job
satisfaction and job performance in surgeons than suggested by
our findings. However, we recognize our reliance on single-item
measures as a limitation in Study 2 and reiterate our call for
replication with fully validated criterion measures.
In addition to the aforementioned issue with the single-
item criterion measures, the study has further limitations. There
is a self-selection bias inherent to most studies that rely on
survey methodologies. Since we have no means of testing
the populations of interest, we cannot rule out the possibility
that our participants self-selected based on their interest in
the topic. Another limitation concerns the relatively small
sample sizes of the design. While we are confident that the
study was sufficiently powered to detect large and medium-
sized effects, future research could endeavor to replicate these
results with larger samples, additional surgical specialties as
well as additional occupational groups. We explicitly recognize
the existence of EI paradigms other than trait EI (e.g., ability
EI by Mayer and Salovey, 1997 or the behavioral model
by Boyatzis, 2009) and caution that an altogether different
pattern of results and/or interpretations may be observed within
those paradigms. These limitations do not detract from the
strengths of the study, which presents rare trait EI data across
multiple surgical specialties but also with reference to other
professional groups, and statistical comparisons down to the
factor level of the construct using a leading multidimensional
measurement instrument.
Detailed assessment of surgeons’ emotional perceptions is
feasible and allows for comparative analyses within surgery,
but also between surgery and other occupations. As per the
expanding literature on trait EI, these perceptions correlate
with several aspects of surgical careers, including job-related
outcomes, stress management strategies, and resilience levels.
This line of research can help with the tailoring of surgical
training curricula across several stages, from post-graduate
education to continuing professional development. It can also
facilitate the design, implementation and uptake of staff support
and wellbeing programs through effective customization for
surgical populations. The current COVID19 pandemic means
such tailoring is an urgent need, though the literature suggests
it is also a long-standing necessity to support surgeons’ successful
and holistic career management. Future studies should explore
surgeons’ trait emotional intelligence in larger samples, and
possibly longitudinally so as to trace potential changes due to
aging and generally increasing professional experience, while also
carrying out similar assessments in non-surgical physicians.
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Petrides et al. Emotional Profiling of Surgeons
DATA AVAILABILITY STATEMENT
The raw data supporting the conclusions of this article will be
made available by the authors, without undue reservation.
ETHICS STATEMENT
The study received full ethical approval from the Camden
and Islington Community Research Ethics Committee and was
performed with the facilitation of the Northern Deanery. The
patients/participants provided their written informed consent to
participate in this study.
AUTHOR CONTRIBUTIONS
KP, MP, PP-D, SJ, HR, NS, and NA performed the material
preparation and collected and analyzed the data. KP and NS
wrote the first draft of the manuscript. All authors contributed
to the study conception and design, commented on previous
versions of the manuscript, and read and approved the
final manuscript.
FUNDING
NS’ research was supported by the National Institute for
Health Research (NIHR) Applied Research Collaboration (ARC)
South London at King’s College Hospital NHS Foundation
Trust. NS was a member of King’s Improvement Science,
which offers co-funding to the NIHR ARC South London
and was funded by King’s Health Partners (Guy’s and St
Thomas’ NHS Foundation Trust, King’s College Hospital NHS
Foundation Trust, King’s College London and South London and
Maudsley NHS Foundation Trust) and Guy’s and St Thomas’
Charity. NS’ research was further supported by the ASPIRES
research programme (Antibiotic use across Surgical Pathways–
Investigating, Redesigning and Evaluating Systems), funded by
the Economic and Social Research Council (ES/P008313/1).
NS was further funded by the National Institute of Health
Research (NIHR) Global Health Research Unit on Health
System Strengthening in Sub-Saharan Africa, King’s College
London (GHRU 16/136/54) using UK aid from the UK
Government to support global health research. Additionally,
the study was supported by National Council for Scientific and
Technological Development (CNPq)–N◦08/2019, under grant
N◦. 150339/2020-8, and H. J. Eysenck Memorial Fund Award
(HJEMFA) to MP.
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Author Disclaimer: The views expressed in this publication are those of the
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of Health and Social Care, CNPq or the HJEMFA.
Conflict of Interest: SJ was employed by company Steve Jeffrey International FZE
LLC. NS was the director of the London Safety and Training Solutions Ltd., which
offers training in patient safety, implementation solutions and human factors to
healthcare organizations.
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