Introduction
Anesthesiology and intensive care medicine are among the most responsible, vital, and fascinating medical disciplines, as they integrate all medical knowledge aimed at preventing critical situations, preserving life and restoring a patient's body functions [1, 2].
The fundamental difference between the work of anesthesiologists and intensive care physicians and other medical specialties lies in the fact that saving lives, patient recovery and the professional success of an intensivist directly depend not only and not even so much on doctor's knowledge, professional skills and abilities, but also on their personal capacity to make decisions, act immediately and ensure effective communication among all participants in the treatment process in critical situations and under highly stressful conditions [2–4]. The absence of these personal qualities can negate all other advantages of the doctor that he or she possesses, although they can also be extremely important [3, 5].
According to leading experts in anesthesiology, resuscitation and intensive care, providing medical care to patients requiring surgical interventions or intensive care measures carries a high risk of developing preventable complications and critical incidents. These risks are often caused by human factors and a lack of effective collaboration between specialists involved in patient care [6].
Critical incidents associated with both surgical intervention and anesthesia account for 12.8–52.2 % of emergency admission to intensive care units (ICUs) [7].
In developed countries, serious complications occur in 3–16 % of emergency surgical interventions, with disability and mortality rates ranging from 0.4 % to 0.8 % [8]. Mortality associated with anesthesia complications occurs in approximately 1 out of 100.000 cases [9].
J.M. Rothschild et al. have shown that 0.8 adverse events and 1.5 serious errors occur per 10 ICU beds per day. The authors report the average frequency of serious errors to be about 149.7 per 1000 patient-days, while 45 % of all the adverse incidents being preventable [10].
Cognitive errors are the leading cause of harm to patient health. There is evidence that simple technical defects or errors account for only a small percentage of diagnostic and treatment errors in the ICU setting [11].
Monitoring defects, poor planning, ineffective teamwork, communication issues, unclear leadership, and a lack of situational awareness and safety systems can have a more significant impact on the outcome of patients requiring surgery or treatment in the ICU than a lack of any knowledge or skill in an individual professional [12].
All the problems mentioned above become most obvious and significant during a circulatory arrest in the operating room and other emergency situations, where standard protocols and templates used in normal conditions are less effective [13–15].
In modern psychological research, terms such as “hard skills” and “soft skills” are widely used. The main difference between “hard skills” and “soft skills” is that the former reflect the specifics of professional activity and can be obtained and assessed in the learning process.
The knowledge, abilities, and skills compassed by the term: “soft skills” refer to universal human competencies. In other words, these are qualities of an individual that are challenging to assess because they are immeasurable and are developed over the course of a person's lifetime [14, 15]. Competencies that can be classified as “soft skills” include communication ability, the ability to work in a team, creativity, punctuality, emotional balance, friendliness, etc. These particular qualities determine an individual's development and psychological well-being, ultimately contributing to success in both personal and professional life. This is true for all professions but is particularly relevant for those occupied in fields where the lives of others depend on the knowledge and skills of a specialist. Examples of such fields include security apparatus, medicine and transportation [16–19].
To illustrate, let us have a look at the personality traits of an ace pilot. While these traits may be numerous, the most important ones, in our opinion, are the desire to engage in air combat and emerge victorious [20]. If we extrapolate these traits to the personality of an anesthesiologist and intensive care physician, the key characteristics of a professional would be a constant readiness to eliminate any adverse incidents and a strong drive to save lives. This desire is reflected in the well-known phrase: “Aliis inserviendo consumor” (“In service to others I burn out myself”). However, it is worth noting that there are very few studies dedicated to exploring the personality traits of anesthesiologists and intensive care physicians. This gap in research served as the motivation for conducting this study.
Objective
The aim of this study is to investigate the opinions of anesthesiologists and intensive care physicians regarding the personality traits deemed essential for effective performance in intensive care settings.
Materials and merhods
An anonymous online survey of anesthesiologists and intensive care physicians (including residents) was conducted using a Google form. A total of 140 respondents took part in the study, of whom 44.3 % were men and 55.7 % were women. Approximately 80 % of respondents were under 35 years of age, and more than 70 % of all the respondents had less than five years of work experience. Most of the participants worked in anesthesiology and resuscitation departments and intensive care units (table 1).
| № | Characteristics | Description | Abs | % |
|---|---|---|---|---|
| 1 | Age | Under 35 years old | 113 | 80.7 |
| 35–45 years old | 13 | 9.3 | ||
| 45–55 years old | 7 | 5 | ||
| 55–60 years old | 6 | 4.3 | ||
| Over 60 years old | 1 | 0.7 | ||
| 2 | Gender | Male | 62 | 44.28 |
| Female | 78 | 55.72 | ||
| 3 | Work experience | Resident | 83 | 59.2 |
| Under 5 years | 19 | 13.5 | ||
| 5–10 years | 13 | 9.2 | ||
| 10–15 years | 6 | 4.2 | ||
| 15–20 years | 5 | 3.6 | ||
| Over 20 years | 14 | 10.3 | ||
| 4 | Department profile | Anesthesiology and Resuscitation department | 95 | 67.8 |
| Anesthesiology department | 17 | 12.1 | ||
| General ICUs | 17 | 12.1 | ||
| Surgical ICUs | 4 | 0.02 | ||
| Specialized ICUs (neurosurgery, cardiovascular surgery, etc.) | 7 | 7.98 |
The Google form was designed in accordance with recommendations on creating questionnaires for healthcare workers and patients [21]. The questionnaire consisted of twelve blocks, which included ninety-seven personality characteristics grouped into the following categories:
- Attentional (5 traits);
- Mnemonic (11 traits);
- Motor (10 traits);
- Sensory (5 traits);
- Visual (5 traits);
- Thinking (10 traits);
- Emotional (8 traits);
- Volitional (13 traits);
- Elocution (6 traits);
- Communicative (9 traits);
- Working Efficiency (9 traits); and
- Observancy (6 traits).
An example of volitional characteristics is presented in table 2.
| № | Personality characteristics |
|---|---|
| 1 | The ability to force yourself to do uninteresting, but necessary work |
| 2 | Ability to defend your point of view |
| 3 | Ability to obey, accurately comply with the instructions |
| 4 | Ability for long-term mental work, without deterioration in quality and decrease in pace |
| 5 | Perseverance in overcoming emerging difficulties |
| 6 | Ability to maintain high activity for a long time (energy) |
| 7 | Low suggestibility, ability to resist influence, especially from authoritative persons |
| 8 | The ability to take responsibility in difficult situations |
| 9 | Ability to objectively assess their achievements, strengths and capabilities |
| 10 | Preservation of collection in conditions stimulating excitation |
| 11 | The effectiveness of overcoming feelings of fatigue |
| 12 | Ability to volitional mobilization |
| 13 | High self-control of emotions and behavior |
Participants were asked to assess the importance of each trait for an anesthesiologist or intensive care physician on a scale from 0 to 2: “0” — No significance for professional activity, “1” — Desirable, and “2” — Absolutely necessary.
Statistical analysis
Data from the electronic questionnaires were collected online and transferred to Microsoft Office Excel 2016 for analysis. The initial data were stored, systematized, and checked for input errors and inaccuracies. The results were then visualized, and descriptive statistics were presented in absolute numbers and percentages.
Results
Based on the survey, fifteen key personality characteristics were identified as having no significant impact on the professional activities of anesthesiologists and intensive care physicians. The top five characteristics included: “Beautiful handwriting”, “Good memory for a person's appearance and behavior”, “Strong, sonorous and endurant voice”, “Quick writing skill”, and “The ability to share another person’s experience and feelings” (table 3).
| № | Personality characteristics | Frequency, % |
|---|---|---|
| 1 | Beautiful handwriting | 45.7 |
| 2 | Good memory for a person's appearance and behavior | 28.6 |
| 3 | Strong, sonorous and endurant voice | 22.2 |
| 4 | Quick writing skill | 21.4 |
| 5 | The ability to share another person’s experience and feelings | 21.4 |
| 6 | No speech defects, good diction | 17.85 |
| 7 | The ability to voluntarily convey one’s ideas or feelings through gestures, facial expressions, and changes in voice | 17.85 |
| 8 | Constancy of good mood | 17.35 |
| 9 | The ability to distinguish temperature changes | 14.3 |
| 10 | The ability to understand undertones (irony, joke) | 12.1 |
| 11 | The ability to distinguish sounds by volume, pitch and timbre | 10.7 |
| 12 | The ability to find attractive aspects in any work | 10.7 |
| 13 | The ability to immediately and accurately convey what has been read once | 10 |
| 14 | The ability to immediately and accurately convey what has been heard once | 10 |
| 15 | Plasticity in movements | 10 |
The personality characteristics that are absolutely necessary for an anesthesiologist and intensive care physician, according to the survey participants, are presented in table 4. The main traits include the following:
- The ability to maintain stable attention for a long time, despite fatigue and extraneous stimuli;
- The ability to see several possible solutions and mentally choose the most effective one;
- The ability to predict the possible outcomes of events and give consideration to their probability;
- The ability to find new and unusual solutions;
- The ability to selectively reproduce the information needed at the moment.
| № | Personality characteristics | Frequency, % |
|---|---|---|
| 1 | The ability to maintain stable attention for a long time, despite fatigue and extraneous stimuli | 84.28 |
| 2 | The ability to see several possible solutions, and mentally choose the most effective one | 73.57 |
| 3 | The ability to predict the possible outcomes of events and give consideration to their probability | 65.7 |
| 4 | The ability to find new and unusual solutions | 49.3 |
| 5 | The ability to selectively reproduce the information needed at the moment | 48 |
| 6 | The ability to effectively envision something new, previously unseen, or something familiar, but in new conditions | 46.4 |
| 7 | The ability to transfer an image from one modality to another or recreate an image from a verbal description | 41.43 |
| 8 | The ability to analyze the problem from different perspectives | 74.28 |
| 9 | The ability to distribute attention when performing several actions, functions, or tasks | 80 |
| 10 | The ability to simultaneously monitor a large number of variables of the observed object | 80 |
| 11 | The ability to act quickly under time pressure | 80 |
| 12 | The ability to quickly switch attention from one activity to another | 79.28 |
| 13 | The ability to notice minor changes in the object under study | 79.28 |
| 14 | Emotional balance and self-control in crisis situations at work | 78.57 |
| 15 | The ability to take responsibility in difficult situations | 77.1 |
| 16 | The ability to coordinate one’s own actions with the actions of others | 77 |
| 17 | The ability to selectively identify relevant information while observing to solve a given problem | 74.28 |
| 18 | The ability to select from a large amount of information the part that is necessary to solve a given problem | 74.28 |
| 19 | The ability to identify the essence of the core relationships within the problem | 72.18 |
| 20 | The ability to conduct a reasoned critical analysis and accept arguments | 72.1 |
| 21 | The ability to objectively assess your achievements, strength and capabilities | 71.4 |
| 22 | The ability to give clear, precise formulations when expressing thoughts concisely (when answering and asking questions) | 71.4 |
| 23 | Coordination of movements and the ability of process real-time information | 70.7 |
| 24 | The ability to make the right decision when there is a lack of necessary information or no time to comprehend it | 70.7 |
| 25 | The ability to clearly convey your thoughts and intentions to the listener | 70.7 |
| 26 | Emotional stability when making responsible decisions | 70 |
| 27 | Maintaining composure in conditions that stimulate excitement | 68.58 |
| 28 | The ability to brace yourself up for intense short-term actions | 68.58 |
| 29 | The ability to defend your point of view | 66.4 |
| 30 | The ability to volitionally recollect strength | 65.7 |
| 31 | High control of one’s own emotions and behavior | 65 |
| 32 | The ability to express thoughts coherently and logically in detailed formats (e.g., reports, papers, or presentations) | 65 |
| 33 | The ability to draw conclusions from contradictory information | 64.98 |
| 34 | Quick reaction to sudden acoustic impact with appropriate movements | 64.28 |
| 35 | The persistence in overcoming difficulties that arise | 63.5 |
| 36 | Interference immunity during work | 62.1 |
| 37 | The ability to determine the nature of information that is missing for decision-making | 60.7 |
| 38 | The ability to maintain a high level of performance through structured, algorithmic actions | 60 |
| 39 | The ability to quickly establish an appropriate tone and communication style with patients | 59.8 |
| 40 | Quick and precise finger movements | 58.6 |
| 41 | The endurance and ability to increase performance at the final stages of work | 58.57 |
| 42 | The ability to force yourself to do uninteresting but necessary work | 57.9 |
| 43 | Quick reaction to sudden visual impact with certain movements | 57.2 |
| 44 | The ability to give an objective assessment of other people's actions | 57.2 |
| 45 | Quick adaptation to new conditions | 56.4 |
| 46 | The ability for long-term mental work without deterioration of quality or reduction of pace | 56.4 |
| 47 | The ability to look beyond immediate and obvious evidence | 55.63 |
| 48 | The ability to concentrate attention on one subject for a sufficiently long period of time | 55 |
| 49 | Efficient work within the approach of short intervals of work and rest | 55 |
| 50 | Efficient work within the approach of long intervals of work and rest | 54.2 |
Personality characteristics that could help anesthesiologists and intensive care physicians achieve success in their professional activities are presented in table 5.
| № | Personality characteristics | Frequency, % |
|---|---|---|
| 1 | The ability to involuntarily memorize information | 65.7 |
| 2 | The ability to share another person’s experience and feelings | 65 |
| 3 | The ability to obey and follow instructions precisely | 65 |
| 4 | The ability to easily memorize figurative visual material (e.g., plans, diagrams) | 64.8 |
| 5 | Constancy of good mood | 64.8 |
| 6 | The ability to easily memorize reasoning verbal information (e.g., terms, dates) | 60 |
| 7 | Plasticity in movements | 59.3 |
| 8 | No speech defects, good diction | 58.55 |
| 9 | The ability to immediately and accurately convey what has been read once | 57.2 |
| 10 | Keen observation of a person's mental condition | 56.4 |
| 11 | Coordination of simultaneous arm and leg movements in various combinations (synchronous, sequential, or mixed) | 55.7 |
| 12 | The ability to distinguish temperature changes | 55.7 |
| 13 | The ability to distinguish sounds by volume, pitch and timbre | 55 |
| 14 | Passion for finding a solution to a problem | 55 |
| 15 | The ability to transmit a positive emotional charge to other people | 55 |
The top three traits were the following: “the ability to involuntarily memorize information”, “the ability to share another person’s experience and feelings”, and “the ability to obey and to follow instructions precisely”.
Discussion
Specific features of higher nervous activity in an individual form the basis for their success in life, from meeting basic needs to excelling in professional activity.
According to psychologist Raymond Cattell, personality factors make it possible to predict what a particular person will do in a certain situation.
The first study focusing on the personality characteristics of anesthesiologists was published by Reeve P.E. back in 1980. However, over thirty years have passed since its publication, and the time brought significant changes have occurred in the professional activities of doctors providing critical care [22].
In a recent study assessing the personal characteristics of modern intensivists, the authors identified six personality types: “the Fixer” (≈ an observer and leader who delegates his powers to the team); “the Retriever” (≈ “to find and remedy something that has gone badly”), "the Diplomat" (≈ “a communicator”), "the Negotiator" (≈ “to solve problems through discussion and negotiation”), "the Pragmatist" (≈ “realistic perception of what is happening, assumption of an unfavorable scenario possibility”), “the Duck” (≈ “appears calm outwardly”). Outsiders might perceive intensivists as “the Super-hero”, “the Naysayer” or “the Dictator” [23].
Thus, the personal qualities of anesthesiologists and intensive care physicians form a solid foundation for acquiring professional knowledge, ensuring successful professional activity, patient safety and favorable disease outcomes [24–26]. Based on the survey, the modern personality of an ideal anesthesiologist and intensive care physician, or “ace doctor”, should possess ten key characteristics (fig. 1).
The main characteristics include the following (listed in order of importance):
- The ability to find the most effective way to solve a problem in a given situation;
- The ability to find and make non-standard decisions;
- The ability to predict an outcome based on the probability assessment of a particular event.
Fig. 1. Personality characteristics of the ideal anesthesiologist and intensive care physician (Credit — authors)
The ability to maintain persistent attention, a good (stable) mood and the ability to follow instructions are crucial for successful teamwork during crisis situations, especially when the decision should be made by other specialists.
The ability to selectively reproduce the information needed at the moment and the ability to easily memorize figurative visual material, as well as the ability to involuntarily remember and reproduce important things that arose at some point in time enables doctors to make quick and optimal decisions in contradictory situations.
One of the personality characteristics that can be useful for an anesthesiologist and intensive care physician is empathy — the ability to share another person’s feelings and experiences. However, this trait is mainly required during communication with colleagues and within routine medical care, rather than in emergency cases. Whereas in critical situations, excessive empathy, compassion, or fear of harming the patient can lead to unreasonable and delayed decisions, potentially worsening the patient’s condition.
It is beyond doubt that in general medicine the ability, the ability to understand and emotionally perceive all the patient's problems and concerns allows doctors to delve deeper into the patient's inner life, becoming his friends and allies in the fight against the disease, and finally making decisions that would alleviate suffering. However, in cases of unfavorable and especially fatal outcomes, this deep connection can lead to a painful condition and psychological disorders in the doctor, potentially confining their effective work in the future.
In our discussion of the results, the work of Raymond A.B. van der Wal et al. (2022) is particularly noteworthy, as it represents the very first systematic review of available data reflecting the anesthesiologists’ personalities. [27]. In this study the four questions were considered:
- Do anesthesiologists differ in personality from the general population?
- Do anesthesiologists differ in personality from other physicians?
- Does personality predict anesthesiologists' performance?
- Does personality predict anesthesiologists' mental health?
After summarizing and analyzing all the data from a few available studies, the authors came to the following conclusions: anesthesiologists exhibit lower levels of neuroticism and extraversion, but they are more conscientious and open compared with the general population.
No significant differences were found between anesthesiologists and other medical specialists. Most researchers concluded that physicians across specialties share more personality similarities than differences. These findings support the concept of a universal personality profile that is equally effective across all medical specialties.
Better professional performance of anesthesiologists was predicted by lower neuroticism, higher extraversion, higher openness and higher conscientiousness.
Higher neuroticism increases the risk of low job satisfaction and mental health problems, while higher extraversion and agreeableness appear to have protective impact.
At the same time, S.V. Kotovskaya et al. (2022) demonstrated that negative or aggressive responses to criticism in high-stress environments and stress conditions should be regarded as stress adaptation mechanisms and should not be interpreted as a conflict. Features of hyperthymia, rigidity and ostentation are essential traits for specialists working in extreme conditions to be able to maintain high performance [28].
The obtained results indicate the importance of careful professional selection for anesthesiologists and intensive care physicians. It is also essential to address or prevent social and psychological issues in doctors with many years of professional experience [4, 5, 29, 30].
Conclusion
The presence of academic professional knowledge, the ability to make quick and correct decisions in non-standard situations and the ability to work in a team are the key personality traits of an anesthesiologist and intensive care physician, all of which contribute to successful practice and favorable emergency outcomes. An ideal anesthesiologist should have a low level of neuroticism, but be rather extraversive and conscientious.
Disclosure. The authors declare no competing interests.
Author contribution. All authors according to the ICMJE criteria participated in the development of the concept of the article, obtaining and analyzing factual data, writing and editing the text of the article, checking and approving the text of the article.
Ethics approval. This study was approved by the local Ethical Committee of Saint-Petersburg state pediatric medical university (reference number: 49/05-27.01.2025).
Funding source. This study was not supported by any external sources of funding.
Data Availability Statement. The data that support the findings of this study are openly available in repository Mendeley Data at https://data.mendeley.com/datasets/6f9fss78dy/1
