Surgeons See Institutional Support as Essential for Second Victim Syndrome

Hsiao L, Kopar PK Surgeon Perception and Attitude Toward the Moral Imperative of Institutionally Addressing Second Victim Syndrome in Surgery. J Am Coll Surg. February 2025.

Second victim syndrome (SVS) describes the significant moral distress healthcare professionals may experience following traumatic patient care events. Although widely recognized in medicine, SVS remains underrecognized in surgery, and systematic approaches to mitigate its potential harms among surgeons are lacking.

When SVS is left unaddressed, surgeons not only suffer personal psychological harm but their ability to care for future patients can also be compromised. Hsiao and Kopar aimed to examine surgeons' perceptions and attitudes regarding the mitigation of SVS.

This study was conducted at a tertiary-care university hospital using a mixed-methods approach that included a 13-item survey, follow-up focus group, and semistructured interviews, The Wilcoxon signed rank test was used for quantitative analysis and content analysis was used to report qualitative findings.

Surgeons viewed SVS as a universal experience and believed healthcare institutions had a moral obligation to address it. Surgeons further believed that any effective mitigation strategy should receive legal protection similar to morbidity and mortality conferences. The culture, tenor, and tone of review processes after surgical complications could either reduce or exacerbate the burden of SVS.

Successful interventions must be easily accessible, voluntary, and culturally acceptable. Surgeons may experience more severe SVS than nonprocedural physicians because adverse events can be inevitable in surgery and may occur frequently in some patient populations. 

Surgeons agreed that healthcare organizations have a moral imperative to help surgeons navigate the psychosocial effects of adverse surgical outcomes. Effective mitigation strategies should be easily accessible, voluntary, culturally acceptable, and supported by an institutional culture that recognizes their importance to both surgeon well-being and patient care.