Electronic Thesis and Dissertation Repository


Master of Science




Dr. Brent Lanting

2nd Supervisor

Dr. Saad Chahine

Joint Supervisor

3rd Supervisor

Dr. James Howard

Joint Supervisor


Surgical trainees experience significant intraoperative stress, which can negatively impact performance and learning. Psychological resilience suggests why some individuals excel despite severe stress. This study explores the relationship between trainee resilience and intraoperative stress. A novel instrument was developed to assess Surgical TRainee Experiences of StresS in the Operating Room (STRESSOR). Focus groups and a literature review identified eight domains of intraoperative stress. STRESSOR was used in a survey of orthopaedic residents in Canada and surgical trainees at Western University. Resiliency was assessed using the 10-item Connor-Davidson Resiliency Scale. 171 responses were received for a 38 percent response rate. The STRESSOR instrument had strong reliability and construct validity using confirmatory factor analysis. Increasing resilience correlated with lower intraoperative stress. Trainees with higher stress or lower resilience were more likely to have considered leaving residency. Resiliency training may reduce intraoperative stress, potentially improving surgical performance and learning while reducing resident attrition.