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Self-confidence in the operating room

Successful surgeons have been described as ambitious, self-assured, and resilient, all qualities that cannot exist without self-confidence. This all-important trait helps shape everything from how your patients perceive you to the way you solve problems. Think you're lacking in self-confidence? There are ways to boost it and increase your happiness at the same time.

You may think everything is easier for the surgeon who brims with self-confidence and to an extent, you would be right. According to Dr Dennis Perman DC, from New York, physicians with self-confidence have an easier time dealing with the day-to-day issues of running a practice, such as staff delegation and patient billing. He notes, “Patients will automatically gravitate toward, and follow the recommendations of, a doctor who is certain and authoritative without being unpleasant about it.”

Self-esteem is the cornerstone of self-confidence, and while the two terms are often used interchangeably, they are different. Self-esteem refers to your overall feeling about yourself—how much positive regard you have. On the other hand, self-confidence is how you feel about your abilities, and this can vary depending on the situation.

Early influences

According to Ellie Young PhD and Laura Hoffmann MEd, professors at Utah's Brigham Young University, a child’s self-esteem is formed early by internal and external factors. They state that while self-esteem may be related to a child’s inborn temperament, research shows that much of the influence over a person’s self-esteem comes from early positive experiences with parents or other significant individuals.

Young and Hoffman suggest that one of the most important traits parents can impart in children is a sense of self-efficacy, a belief that one can accomplish a particular goal. “Helping children develop self-esteem is a matter of helping them gather evidence that they are competent and capable,” they assert.

Research shows that acquiring self-efficacy pays off handsomely as children develop. In school, the characteristic is a powerful predictor of a child’s educational achievement, says Mark Leary, professor of psychology at Wake Forest University and noted researcher on self-esteem. In the Handbook of Self he notes that adults with self-efficacy are more likely to tackle something new, set lofty goals, and work to overcome obstacles.

Make a self-confidence plan

Most self-help books will touch on the importance of becoming aware of the messages you tell yourself, also known as self-talk. Is your self-talk negative? Then it’s important to work on delivering more positive messages to yourself.

In a professional capacity, some confidence naturally comes from experience. Journalist and bestselling author Malcolm Gladwell summed it up as the “10,000 hour rule”. The more someone practices a task in a given field, the more natural the task and the more successful the person becomes.

Nowhere is this adage more prevalent than in the field of spinal surgery. A 2006 University of British Columbia study examined the confidence of senior neurosurgical and orthopedic residents in performing spinal surgical procedures. The neurosurgical residents reported a significantly higher level of confidence for performing surgical spinal procedures. Why?

The neurosurgical residents spent 37% of their total residency time devoted to the spine while the orthopedic residents devote just 16% of their time to it.

Be more confident at work: 10 easy steps

1—Eliminate self-doubt <br/>The path to improving confidence has two phases. First, you must eliminate all self-doubt; second, you develop your confidence. Once the groundwork is completed, how much confidence you cultivate is up to you.<br/> <br/>

2—Accept your shortcomings <br/>Recognizing that you have low confidence is the first gift you can give yourself. Everyone has imperfections. Acceptance gives you the power to make the necessary changes to ease your distress. <br/> <br/>

3—Tell someone you trust <br/>Admitting your shortcomings to yourself is only the first part of the solution—now confess your self-doubt to someone you trust. Chances are you will learn others share self-doubt issues too. This should ease your anxiety.<br/> <br/>

4—Tally up your merits <br/>Grab a pen and paper and write down the things you have going for you. Dissect your skill set. What have you accomplished so far? Read your list aloud if this helps.<br/> <br/>

5—Overcome obstacles<br/>Life will throw crazy, difficult events in your path, it happens to everybody. You can weather the hard stuff by telling yourself you can, and will, cope with it. Perception is everything. Remember the saying: -Mind over matter.-<br/> <br/>

6—Face your fears <br/>Fear can stifle your honest attempts to change. Confront fear by doing the things that scare you the most. Sure, you may encounter some setbacks but resilience is the backbone of confidence. You will surprise yourself and find success where you least expected to.<br/> <br/>

7—Select your own challenges <br/>Take on challenges of your own choosing. Tackling someone else's challenges just won't produce the results you are looking for. Engage yourself in a task you believe in—it will be easier to strive for success if you have confidence in the goal.<br/> <br/>

8—Up the ante by adding challenges <br/>Your confidence will grow with each challenge you overcome but boredom is a sure-fire way to erode your growing self-confidence. Make sure you keep challenging yourself in new and exciting ways.<br/> <br/>

9—Avoid seeking feedback to boost your confidence<br/>When looking to boost your confidence asking -How am I doing?- is not a good question. It reeks of insecurity and rarely leads to sincere feedback. <br/> <br/>

10—Too much of a good thing <br/>Feeling confident? Great. But don't forget that there can be too much of a good thing. You are aiming for enough confidence to be bold and create the life you want, not cross the border into arrogance and conceit. Believe in yourself graciously!<br/> <br/>

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Fake it until you make it

It’s clear that the most important piece of the self-confidence puzzle comes from within. But there are also easy steps you can take to change the way others perceive you and the way you feel about yourself, just by changing your body language.

Demonstrating self-confidence is especially important for the young surgeon, says Illinois foot and ankle specialist Bradly Bussewitz DPM, since patients have more confidence in the middle-aged surgeons and assume they have more hours on the job.

“Enter the room with confidence,” he states. “If shaking the patient’s hand is your thing, shake it with eye contact and a firm grip. Confer the message ‘I’ve been here before and I know what I am doing.’ If you stand, stand without fidgeting. If you sit, do not slump in your chair.”

Interestingly, some research suggests the more you practice confident body language the more confident you will become.

For those lacking in self-confidence, the trait can seem to be an all or nothing quality. But while you can’t change the impact your past asserts on your current state of confidence you can still work towards positively influencing your future confidence levels. The hard work is worth it.

LINKS

Study "Confidence in spine training among senior neurosurgical and orthopedic residents" (PubMed)
http://www.ncbi.nlm.nih.gov/pubmed/16582858

TED Talk by Amy Cuddy PhD, social psychologist and associate professor at Harvard Business School (YouTube): "Your body shapes who you are" http://www.ted.com/talks/amy_cuddy_your_body_language_shapes_who_you_are.html

Book by Tim Urisiny, PhD, motivational trainer, "The Confidence Plan: How to Build a Stronger you" http://www.amazon.com/The-Confidence-Plan-Build-Stronger/dp/1402203497

Counterview

Less-confident people are more successful!

by Tomas Chamorro-Premuzic

Overwhelmed by the thought of tackling your lack of confidence? Not everybody jumps on the confidence bandwagon. One Harvard Business Review blogger and Professor of Business Psychology at University College London (UCL) offers his opposing view that sometimes low confidence can be your ally and help you realize your goals.

There is no bigger cliché in business psychology than the idea that high self-confidence is key to career success. It is time to debunk this myth. In fact, low self-confidence is more likely to make you successful.

After many years of researching and consulting on talent, I've come to the conclusion that self-confidence is only helpful when it's low. Sure, extremely low confidence is not helpful: it inhibits performance by inducing fear, worry, and stress, which may drive people to give up sooner or later. But just-low-enough confidence can help you recalibrate your goals so they are (a) more realistic and (b) attainable. Is that really a problem? Not everyone can be CEO of Coca Cola or the next Steve Jobs.

If your confidence is low, rather than extremely low, you stand a better chance of succeeding than if you have high self-confidence. There are three main reasons for this:

Lower self-confidence makes you pay attention to negative feedback and be self-critical: Most people get trapped in their optimistic biases, so they tend to listen to positive feedback and ignore negative feedback. Although this may help them come across as confident to others, in any area of competence (eg, education, business, sports or performing arts) achievement is 10% performance and 90% preparation. Thus, the more aware you are of your soft spots and weaknesses, the better prepared you will be. Low self-confidence may turn you into a pessimist, but when pessimism teams-up with ambition it often produces outstanding performance. To be the very best at anything, you will need to be your harshest critic, and that is almost impossible when your starting point is high self-confidence. Exceptional achievers always experience low levels of confidence and self-confidence, but they train hard and practice continually until they reach an acceptable level of competence. Indeed, success is the best medicine for your insecurities.

Lower self-confidence can motivate you to work harder and prepare more: If you are serious about your goals, you will have more incentive to work hard when you lack confidence in your abilities. In fact, low confidence is only demotivating when you are not serious about your goals.