An investigation of mental readiness and its links to performance excellence in surgery.

Abstract

The purpose of this study was to assess factors that are related to excellence among surgeons. The sample included 33 highly proficient surgeons involved in high- and low-mortality-risk surgery, seven of whom were known by reputation as "elite". A framework developed by researchers in athletics was used to examine how surgeons perform their best in challenging elective procedures. Individual in-depth interviews were carried out to determine their mental readiness before, during and after surgery. This provided a quantitative and qualitative analysis of mental readiness. These findings were compared with Orlick's "Theory of Human Excellence" which is based on results from world-class athletics and other high-performance domains. Common elements of success were found which included: commitment, belief, positive images, mental readiness, full focus, distraction control, and constructive evaluation. Major performance blocks were identified which interfered with optimal performance. Characteristics which distinguished certain groups of surgeons were identified. This investigation confirmed that there were many similarities in mental preparation procedures and perspectives engaged in by top surgeons and top athletes. Practical recommendations for mental training were provided relevant to excellence in the surgical arena.