Commentary: The need for emotional intelligence coaching in cardiothoracic surgery

The epidemic of burnout among cardiothoracic surgeons eloquently described by Manji and colleagues¹ is the product of a systematic failure to recognize and proactively address cognitive and psychological factors and risks inherently associated with a safety-critical profession like ours. The specialty of cardiothoracic surgery is relatively young (the coronary artery bypass grafting procedure turned 50 in 2014), and has only recently moved from a pioneering phase to a more mature approach that embraces its role in larger health care teams and acknowledges human fallibility. For too long, cardiothoracic surgeon training and our professional organizations have prioritized technical skills and technology enhancements to advance our profession; we can no longer afford to neglect the nontechnical skills that are essential to succeed. Furthermore, leadership development in cardiothoracic surgery increasingly requires mastering core proficiencies such as team and consensus building, strategic planning, and change management that require emotional intelligence as well as superb communication and collaboration skills.²

Emotional intelligence, a concept pioneered by Daniel Goleman in 1995,³ stands out as a key competence that has been ignored by cardiothoracic surgeons (Figure 1). An emotionally intelligent individual is both highly conscious of his or her own emotional states—even negative ones like frustration, anger, and sadness—and is able to identify and manage them. Unfortunately, it is still not fully appreciated that a sensitivity to emotional signals both from within oneself and from one’s social environment, including the operating room, could make one a better surgeon and reduce the risk of burnout.⁴ According to Goleman,³ there are 5 elements to emotional intelligence: self-awareness, self-regulation, motivation, empathy, and social skills. We can all become more emotionally intelligent and avoid burnout by responding rather than reacting to conflicts, use active listening skills, practice ways to maintain positive attitudes, practice self-awareness, accept critiques, and empathize with others. The rewards of an emotionally intelligent surgeon are better teamwork inside and outside the operating room, easier adjustment to change (eg, working closer with cardiology colleagues), greater self-awareness (eg, knowing your strengths and weaknesses, avoiding overpromising and underdelivering), greater self-control (eg, handling a difficult situation with a patient or a colleague by staying calm and avoiding emotional outbursts), fewer errors, and less risk of burnout.

FIGURE 1.

The five elements of emotional intelligence according to Goleman.

A professional certified coach in emotional intelligence may be the best choice to introduce surgeons to emotional intelligence practices of self-observation, self-regulation, empathic listening, and so on. Among the options available when seeking professional coaching, the Institute of Coaching (IOC) at McLean Hospital and Harvard Medical School (www.instituteofcoaching.org) offers qualified support. Another option is to visit the International Federation of Coaching (ICF)’s website where accredited and qualified members are listed (www.coachfederation.org).