Working in an operating theatre is a highly competitive sport. High work pressure, stress, and unexpected developments during operations. This requires a lot from care professionals who need to be mentally resilient to be able to deliver peak performances time and time again. What makes a care professional resilient? And how does leadership work in an operating theatre?
An interdisciplinary research team made up of Eduard Schmidt (assistant professor Institute of Public Administration, FGGA, specialising in leadership), Yannick Balk (sports psychologist, assistant professor University of Amsterdam), Marieke Adriaanse (professor FSW/LUMC), and Jaap Hamming (surgeon and professor LUMC) has received a grant of 122,000 Euros from Dutch health research organisation ZonMw for a research project on leadership, resilience, and self-regulation in operating theatres. Schmidt and Balk will be doing the hands-on research: starting by being physically present during operations at the LUMC (Leiden University Medical Centre).
Keep performing in stressful situations
Research into operation theatre collaborations. It appears to be somewhat lacking, but the team is about to change that. Schmidt: 'Medical research often focusses on clinically related issues, but we're more interested in finding out how people interact with each other. What is it that makes teams able to deliver peak performances time and time again? Where do they find the strength to bounce back from setbacks and just keep on going? For instance, when a patient's loosing too much blood? What do you do and how does the team respond?'
Balk adds: 'Our research has a positive angle. What's going well and which skills are at the basis for that? Think of dealing with stress and emotions. How do you prepare yourself for that? And what if you've slept badly, what do you do to still be able to perform? What makes someone a resilient care professional and what can we and others learn from that?'
Eduard Schmidt: 'During the observations, we'll look for several things. The way people communicate with each other. How discussions and feedback are handled. What's also interesting is seeing if and who dares to speak up when they have doubts. I believe that the best way to address this is by actually being present in the room.'
Observations in the operating theatre
For their research, the duo will have to don PPE (personal protective equipment) and start by doing observations in the operating theatre. Schmidt: 'During the observations, we'll look for several things. The way people communicate with each other. How discussions and feedback are handled. What's also interesting is seeing if and who dares to speak up when they have doubts. I believe that the best way to address this is by actually being present in the room. We'll combine the observations of operations with conducting interviews. For which we'll be focussing on all care professionals; the surgeons but also the operating assistants, anaesthesiologists, and medial trainees, to make sure everybody's voice is heard.'
In this so-called action research, the outcomes will be used to conduct follow-up research. Balk: 'With the outcomes in mind, we'll try to identify interesting follow-up questions and change our surveys accordingly. In this quantitative research, people will fill in short questionnaires at several intervals.'
Desired behaviours in the operating theatre
At the LUMC, the project has been received with enthusiasm. The changes in society also find their way into the operating theatre. The surgeon is obviously still the mainly responsible for the operation, but the input of the entire team is becoming more and more important. Balk: 'The team should feel at ease in order to perform. We all have prejudices about the way surgeons act: direct, at the top of the hierarchy, dominant, but is that really true? It's good to come together and discuss which behaviours from a surgeon but also from the other team members are desired to make the team perform optimally.'
In a year from now, the researchers hope to have a blueprint ready that can be used in educational health care programmes to see which behaviours contribute to the resilience of care professionals. Schmidt: 'It'd be wonderful if you can prevent people from reverting to directive and defensive behaviours when things get though. Sharing knowledge and proposing small changes, such as letting go of certain routines or getting used to certain habits seems to be more efficient than sending everyone to a leadership training.'
Tekst: Margriet van der Zee
Translation: Marleen van Koetsveld
Images: header Stockphoto, second photo: private collection Yannick Balk
