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Intraoperative Disruptive Behavior: The Medical Student's Perspective
Kristin L Chrouser1, Melissa R Partin2
1Department of Urology, University of Minnesota and University of Michigan, Minneapolis VA Health Care Center, Minneapolis, Minnesota.
Journal of Surgical Education
|April 29, 2019
Summary
Medical students report that intraoperative disruptive behavior, often from surgeons, harms teamwork and learning. Addressing surgeon frustration is key to creating calmer, more collaborative surgical environments.
Area of Science:
- Medical Education
- Surgical Team Dynamics
- Patient Safety
Background:
- Intraoperative disruptive behavior negatively impacts psychological safety, teamwork, and communication.
- Medical students possess unique insights into preventing these adverse effects.
Purpose of the Study:
- Characterize medical student perspectives on the causes and consequences of intraoperative disruptive behavior.
- Identify ideal intraoperative working environments from a student viewpoint.
Main Methods:
- Retrospective qualitative analysis of de-identified field notes from residency interviews.
- Coding of notes to identify themes and key insights.
- Exploration of gender differences in perspectives.
Main Results:
- Most students witnessed disruptive behavior (yelling, throwing instruments) by surgeons.
- Common instigators included missing instruments and perceived assistant incompetence.
- Undesirable effects: decreased communication, hindered learning, increased errors, fear, and stress.
- Ideal environments: calm, efficient, collaborative, encouraging questions and learning.
Conclusions:
- Medical students offer valuable perspectives on intraoperative disruptive behavior.
- Reducing surgeon frustration may be an effective intervention strategy.
- Student insights can guide efforts to improve surgical working environments.