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All surgical procedures carry with them the potential for adverse events, the complications and errors that may arise in the course of normal practice. Dealing with the sequelae of surgery is part and parcel of a surgeon’s working life: they must respond to the challenge of providing effective patient care, and may also need to deal with the reaction of the patient’s family, with the judgments of colleagues and, in some cases, with disciplinary or legal proceedings. 


Despite the ubiquity of such events for surgeons, very little research has examined how surgeons are affected psychologically when things do go wrong. Nevertheless, it is well recognised that these experiences may have profound effects with surgeons having been called the second victims of adverse events. Personal distress in surgeons affects not only work satisfaction but also the quality of care they provide, apparently increasing the odds of subsequent medical errors. 

Our research will generate a national picture within the UK of the impact of both complications and errors on surgeons, to investigate moderators and mediators of such reactions with the aim of ameliorating negative impacts to allow surgeons to continue to flourish within their working and personal lives. 



Dr. Helen Bolderston is an academic and practicing clinical psychologist. She has worked for over 25 years as a clinical psychologist, predominantly in NHS Adult Mental Health services. She managed the Bournemouth Adult Mental Health Psychology and Counselling service in Dorset HealthCare University NHS Foundation Trust for several years. More recently, her career has moved in an academic direction, with a senior lecturer post at Bournemouth University. Her research focusses on three main areas: 1. Evaluating psychotherapeutic interventions, particularly mindfulness-based therapies such as Acceptance and Commitment Therapy. 2. Investigating the psychological processes implicated in the development and maintenance of mental health problems. 3. Increasing understanding of  psychological wellbeing and burnout in health and social care students and professionals.

Professor Kevin Turner is a Consultant Urological Surgeon in Bournemouth and a Visiting Professor at Bournemouth University. He trained in Cambridge, Oxford, Edinburgh and Melbourne. His principal interests are in urological cancer and particularly resectional surgery for pelvic / renal malignancy including laparoscopic and robotic surgery. He is committed to training and developing young surgeons: he is a former faculty member for the Training the Trainers course (Royal College of Surgeons of England), he is a current FRCS Urology oral examiner, and is an educational and clinical supervisor to urological trainees. He is an experienced researcher and has published regularly during his career. He is co-editor of the Oxford Handbook of Urological Surgery (OUP 2008), has published several book chapters and numerous original research papers, abstracts, and review articles. His research on angiogenesis in renal cancer was awarded a Royal College of Surgeons Research Fellowship and the European Association of Urology Thesis Award. The quality of this research was recognised when he was elected to the office of Hunterian Professor of the Royal College of Surgeons whilst still a trainee.


Catherine Withers is a PhD researcher at Bournemouth University. Her background is in education, having gained her PGCE in 2010 and teaching for 4 years in head of department and behaviour specialist roles. Catherine then completed an MSc in Psychology focusing on the efficacy of digit span testing as a measure of actual short-term memory capacity in children, utilising quantitative research methods, statistical analysis and application to cognitive theory within her research. Catherine was drawn to this area of research as it appeals to her psychological interests in both clinical and cognitive psychology and appeases her desire to make a positive impact on the quality of life of others. 

Professor Siné McDougall is an experienced researcher who is used to managing research teams and has extensive experience of supervising postgraduate students. Her research focuses on two main areas. The first is concerned with evaluating the efficacy of training interventions including medical training in anesthetists, reading acquisition in children, and the efficacy of brain training in older adults. She also has an interest in human factors, particularly how we understand, learn and use icons and symbols on interfaces. Current research is examining the way we interpret and learn auditory warnings from machinery in operating theatres and the factors influencing effective and timely diagnosis of Klinefelter’s syndrome.

Dr. Kevin Thomas is an experienced researcher whose expertise is primarliy in decision-making, particularly decision-making in applied setting such as healthcare and finance. His research falls into three areas: the interplay between various dimensions of emotion and decision-making,; bias in judgerments of future task perfromance; and the benefits of counterfactual thinking about past behaviours for improving future behaviours. Kevin has published widely and has secured research grants from bodies including the Economic and Social Research Council (ESRC).

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Stephen Richer is a PhD researcher at Bournemouth University. His background is mental health nursing and he has worked in numerous roles within the NHS and for various mental health charities. Stephen returned to academia in 2010 and gained a BSc in Psychology, his dissertation focusing on cognitive psychology, including Framing Effect and Cognitive Heuristics. In 2014 he completed an MSc in Clinical Psychology where his main areas of study were Post Traumatic Stress Disorder and Emotional Processing. Stephen’s interests in this research project were the result of his experience in clinical and cognitive psychology both from his previous roles in the NHS and his recent academic work.  A desire to improve the quality of life of individuals has been the driving force in much of Stephen’s career.


The aim of this research is systematically to compare the impact on surgeons of adverse events - both complications and errors - with a longer-term goal of providing them with better support and training.

We will examine:-

  • The difference between complications and errors.

  • The personal and case-related impact of adverse events.

  • The role of surgeons’ coping styles, cognitive framing of emotional experiences (e.g. counter- factual thinking), and current wellbeing (e.g., perceived quality of life) in modulating the impact of adverse events.

  • The availability and effectiveness of formal and informal support available following adverse events.

  • The potential mediating effect of Psychological Flexibility


Data from the survey will provide data to allow:-

  • Constructive and supportive awareness of the personal impact of adverse events.

  • Support for dealing with the impact of adverse events.

  • Improved training.

  • The potential to support government policy change


Research Objectives:-

  • To establish a clear distinction between surgical complications and surgical errors and disseminate findings through publication

  • To develop a questionnaire allowing clinicians to evaluate their strengths and vulnerabilities and analyse the impact of complication and errors on surgeons

  • To provide quantifiable leverage for influencing policy change

  • To guide the development of better targeted education and support for surgeons.

  • To examine the factors likely to facilitate the creation of a support culture within the medical profession.