{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T21:13:44Z","timestamp":1787606024331,"version":"build-2736575974"},"reference-count":57,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T00:00:00Z","timestamp":1733356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Clear definitions are essential in science, particularly in the study of abstract phenomena like creativity. Due to its inherent complexity and domain-specific nature, the study of creativity has been complicated, as evidenced by the various definitions used to describe it and the multitude of tools which claim to measure it. Surgery is a safety-critical profession where creativity could be useful in navigating unforeseen problems and circumstances, as well as developing new innovations to improve patient outcomes. To validly and reliably study creativity in surgery, a surgery-specific definition is required. We aim to develop a consensus definition of creativity in surgery, utilizing the existing creativity literature and surgeon input.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods and analysis<\/jats:title>\n<jats:p>The objective of this study is to generate a consensus definition of creativity in surgery. We will first conduct a focus group comprised of 4\u201312 highly experienced surgeons to generate knowledge on surgeons\u2019 perceptions, attitudes and beliefs about creativity in surgery, collect real-world examples of creativity in surgery, and obtain opinions on the existing definitions of creativity in the literature. The selection of focus group participants will be performed using purposive sampling of the chairs and\/or chiefs of each surgical sub-specialty at our home institution. Several questions relating to creativity in surgery will be posed to the focus group, to be rated using a 7-point Likert scale and used as prompts for group discussion. We will also search MEDLINE, PsycINFO and EMBASE to find definitions of creativity in the scientific literature. Six definitions, chosen based on citation frequency and relevancy to surgery, will be presented to the focus group for ranking and discussion. Lastly, in addition to novelty and effectiveness, which are widely accepted as necessary components of creativity, the focus group will be asked to consider the necessity of other components for creativity in surgery, sourced from the scientific literature. Descriptive and thematic analyses are planned for the quantitative and qualitative data, respectively. The results of the focus group will be incorporated in the drafting of five definitions of creativity in surgery, which will be presented as initial Delphi statements in the Delphi study. For the Delphi panel, we will perform non-probability purposive sampling of surgeons and surgeon trainees at our home institution, with a minimum panel size of 12. Panellists will be asked to select the definition of creativity most relevant to surgery, with each Delphi round electronically delivered. After each round, the steering committee will meet to review the results and adjust the statements for the next round based on the feedback. A maximum of 5 rounds will be performed, or until consensus is reached (\u226575% agreement). Recruitment is scheduled to begin on 1 August 2024.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Ethics and dissemination<\/jats:title>\n<jats:p>All focus group and panellists will be given written and verbal information on the study and provide signed, informed consent. We plan to publish the results of our study in a creativity science- or surgery-focused journal to disseminate the results of our study to relevant stakeholders. We also plan to present the results of our research at local, national, and international conferences.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0314445","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T18:28:32Z","timestamp":1733423312000},"page":"e0314445","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["A consensus definition of creativity in surgery: A Delphi study protocol"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1516-9584","authenticated-orcid":true,"given":"Alex","family":"Thabane","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"McKechnie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Staibano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4268-475X","authenticated-orcid":true,"given":"Vikram","family":"Arora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goran","family":"Calic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0178-8712","authenticated-orcid":true,"given":"Jason W.","family":"Busse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9407-5622","authenticated-orcid":true,"given":"Sameer","family":"Parpia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohit","family":"Bhandari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"issue":"3","key":"pone.0314445.ref001","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1086\/287675","article-title":"The functions of definition in science","volume":"26","author":"P. Caws","year":"1959","journal-title":"Philosophy of Science"},{"issue":"9","key":"pone.0314445.ref002","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1037\/h0063487","article-title":"Creativity","volume":"5","author":"J Guilford","year":"1950","journal-title":"American Psychology"},{"issue":"5","key":"pone.0314445.ref003","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1002\/hbm.20633","article-title":"Neural networks involved in artistic creativity","volume":"30","author":"Y Kowatari","year":"2009","journal-title":"Hum Brain Mapp"},{"key":"pone.0314445.ref004","unstructured":"Amabile T. Componential theory of creativity: Harvard Business School Boston, MA; 2011."},{"issue":"7","key":"pone.0314445.ref005","first-page":"305","article-title":"An Analysis of Creativity","volume":"42","author":"M. Rhodes","year":"1961","journal-title":"The Phi Delta Kappan"},{"issue":"2","key":"pone.0314445.ref006","first-page":"15","article-title":"The amusement park theoretical (APT) model of creativity","volume":"14","author":"JC Kaufman","year":"2004","journal-title":"The International Journal of Creativity & Problem Solving"},{"issue":"1","key":"pone.0314445.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1159\/000277029","article-title":"An investment theory of creativity and its development","volume":"34","author":"RJ Sternberg","year":"1991","journal-title":"Human development"},{"issue":"2","key":"pone.0314445.ref008","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1080\/10400419.2011.571191","article-title":"The cognitive neuroscience of creativity: A critical review","volume":"23","author":"K. Sawyer","year":"2011","journal-title":"Creativity research journal"},{"issue":"3","key":"pone.0314445.ref009","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/j.2162-6057.2010.tb01333.x","article-title":"Redefining creativity\u2014analyzing definitions, collocations, and consequences","volume":"44","author":"PG Kampylis","year":"2010","journal-title":"The Journal of Creative Behavior"},{"issue":"2","key":"pone.0314445.ref010","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1207\/s15326985ep3902_1","article-title":"Why isn\u2019t creativity more important to educational psychologists? 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Eisenman","year":"1987","journal-title":"Bulletin of the Psychonomic Society"},{"key":"pone.0314445.ref025","doi-asserted-by":"crossref","first-page":"565884","DOI":"10.3389\/fpsyg.2020.565884","article-title":"What Does Creativity Mean in Safety-Critical Environments?","volume":"11","author":"S. Bourgeois-Bougrine","year":"2020","journal-title":"Front Psychol"},{"key":"pone.0314445.ref026","doi-asserted-by":"crossref","first-page":"628","DOI":"10.2307\/2393339","article-title":"1993 \u2018The collapse of sensemaking in organizations: The Mann Gulch disaster","volume":"38","author":"K. Weick","year":"1993","journal-title":"Administrative Science Quarterly"},{"issue":"2","key":"pone.0314445.ref027","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.surg.2005.06.017","article-title":"Non-technical skills for surgeons in the operating room: a review of the literature","volume":"139","author":"S Yule","year":"2006","journal-title":"Surgery"},{"issue":"8","key":"pone.0314445.ref028","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1046\/j.1365-2168.1999.01169.x","article-title":"Consultant surgeons\u2019 opinion of the skills required of basic surgical trainees","volume":"86","author":"PJ Baldwin","year":"1999","journal-title":"Br J Surg"},{"issue":"3","key":"pone.0314445.ref029","first-page":"256","article-title":"Focus group discussion: a tool for health and medical research","volume":"49","author":"LP Wong","year":"2008","journal-title":"Singapore Med J"},{"issue":"5","key":"pone.0314445.ref030","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/intqhc\/8.5.499","article-title":"Focus groups","volume":"8","author":"RA Powell","year":"1996","journal-title":"Int J Qual Health Care"},{"issue":"4","key":"pone.0314445.ref031","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5662\/wjm.v11.i4.116","article-title":"Delphi methodology in healthcare research: How to decide its appropriateness","volume":"11","author":"P Nasa","year":"2021","journal-title":"World J Methodol"},{"key":"pone.0314445.ref032","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2020.00457","article-title":"Delphi Technique in Health Sciences: A Map","volume":"8","author":"M Niederberger","year":"2020","journal-title":"Frontiers in Public Health"},{"issue":"3","key":"pone.0314445.ref033","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1287\/mnsc.9.3.458","article-title":"An Experimental Application of the DELPHI Method to the Use of Experts","volume":"9","author":"N Dalkey","year":"1963","journal-title":"Management Science"},{"key":"pone.0314445.ref034","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2022.841816","article-title":"Consensus Definition of Misophonia: A Delphi Study","volume":"16","author":"SE Swedo","year":"2022","journal-title":"Frontiers in Neuroscience"},{"issue":"12","key":"pone.0314445.ref035","doi-asserted-by":"crossref","first-page":"2573","DOI":"10.1038\/s41366-018-0313-9","article-title":"A Delphi study to build consensus on the definition and use of big data in obesity research","volume":"43","author":"C Vogel","year":"2019","journal-title":"International Journal of Obesity"},{"issue":"12","key":"pone.0314445.ref036","doi-asserted-by":"crossref","first-page":"3028","DOI":"10.1111\/trf.16055","article-title":"A Delphi study to establish consensus on a definition of major bleeding in adult trauma","volume":"60","author":"HS Wong","year":"2020","journal-title":"Transfusion"},{"key":"pone.0314445.ref037","article-title":"Consensus on the definition of advanced Parkinson\u2019s disease: a neurologists-based Delphi study (CEPA study)","volume":"2017","author":"M-R Luquin","year":"2017","journal-title":"Parkinson\u2019s disease"},{"issue":"11","key":"pone.0314445.ref038","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1136\/annrheumdis-2017-212515","article-title":"Consensus proposal for taxonomy and definition of the autoinflammatory diseases (AIDs): a Delphi study","volume":"77","author":"E Ben-Chetrit","year":"2018","journal-title":"Annals of the rheumatic diseases"},{"issue":"4","key":"pone.0314445.ref039","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1080\/02687038.2020.1852003","article-title":"Establishing consensus on a definition of aphasia: an e-Delphi study of international aphasia researchers","volume":"36","author":"K Berg","year":"2022","journal-title":"Aphasiology"},{"key":"pone.0314445.ref040","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13104-019-4857-0","article-title":"Stroke secondary prevention, a non-surgical and non-pharmacological consensus definition: results of a Delphi study","volume":"12","author":"M Lawrence","year":"2019","journal-title":"BMC Research Notes"},{"issue":"3","key":"pone.0314445.ref041","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/uog.15884","article-title":"Consensus definition of fetal growth restriction: a Delphi procedure","volume":"48","author":"S Gordijn","year":"2016","journal-title":"Ultrasound in Obstetrics & Gynecology"},{"issue":"11","key":"pone.0314445.ref042","first-page":"299","article-title":"Importance of focus groups in qualitative research","volume":"8","author":"M Gundumogula","year":"2020","journal-title":"International Journal of Humanities and Social Science (IJHSS)"},{"key":"pone.0314445.ref043","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/1471-2288-11-26","article-title":"What about N? A methodological study of sample-size reporting in focus group studies","volume":"11","author":"B Carlsen","year":"2011","journal-title":"BMC Med Res Methodol"},{"key":"pone.0314445.ref044","unstructured":"Slido. Cisco Systems Inc.; 2024."},{"issue":"3","key":"pone.0314445.ref045","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1080\/10400419.2014.929424","article-title":"Creativity.4in1: Four-Criterion Construct of Creativity","volume":"26","author":"AV Kharkhurin","year":"2014","journal-title":"Creativity Research Journal"},{"issue":"2\u20133","key":"pone.0314445.ref046","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1080\/10400419.2012.676974","article-title":"Taking the U.S. Patent Office Criteria Seriously: A Quantitative Three-Criterion Creativity Definition and Its Implications","volume":"24","author":"DK Simonton","year":"2012","journal-title":"Creativity Research Journal"},{"issue":"1","key":"pone.0314445.ref047","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.tsc.2008.10.001","article-title":"In-service and prospective teachers\u2019 conceptions of creativity","volume":"4","author":"P Kampylis","year":"2009","journal-title":"Thinking skills and creativity"},{"issue":"2","key":"pone.0314445.ref048","first-page":"3","article-title":"Creative thinking in business organizations","volume":"12","author":"LW Boone","year":"1990","journal-title":"Review of business"},{"key":"pone.0314445.ref049","first-page":"1","article-title":"Updating the Standard Definition of Creativity to Account for the Artificial Creativity of AI","author":"MA Runco","journal-title":"Creativity Research Journal"},{"issue":"8","key":"pone.0314445.ref050","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1080\/0142159X.2020.1755030","article-title":"Thematic analysis of qualitative data: AMEE Guide No. 131","volume":"42","author":"ME Kiger","year":"2020","journal-title":"Medical teacher"},{"issue":"1","key":"pone.0314445.ref051","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/26895269.2022.2129597","article-title":"Toward good practice in thematic analysis: Avoiding common problems and be(com)ing a knowing researcher","volume":"24","author":"V Braun","year":"2023","journal-title":"International Journal of Transgender Health"},{"issue":"3","key":"pone.0314445.ref052","doi-asserted-by":"crossref","first-page":"214","DOI":"10.5014\/ajot.45.3.214","article-title":"Rigor in Qualitative Research: The Assessment of Trustworthiness","volume":"45","author":"L. Krefting","year":"1991","journal-title":"The American Journal of Occupational Therapy"},{"issue":"1","key":"pone.0314445.ref053","doi-asserted-by":"crossref","first-page":"e56","DOI":"10.1002\/ffo2.56","article-title":"Improving the question formulation in Delphi-like surveys: Analysis of the effects of abstract language and amount of information on response behavior. 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