Concerns About Verbal Communication in the Operating Room: A Field Study
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Updated: Jan 22, 2026

Modeling Verbal Behavior Deficits with the Stimulus Control Ratio Equation, SCoRE
Published on: May 14, 2019
Ehsan Garosi1, Reza Kalantari2, Ahmad Zanjirani Farahani3
1Tehran University of Medical Sciences, Iran.
Objective:
To assess verbal communication patterns which could contribute to poor performance among surgical team members in an operating room.
Background:
There exist certain challenges in communication in health care settings. Poor communication can have negative effects on the performance of a surgical team and patient safety. A communication pattern may be associated with poor performance when the process of sending and receiving information is interrupted or the content of conversation is not useful.
Method:
This cross-sectional field study was conducted with 54 surgical teams working in two Iranian hospitals during 2015. Two observers recorded all verbal communications in an operating room. An in-depth assessment of various annotated transcripts by an expert panel was used to assess verbal communication patterns in the operating room.
Results:
Verbal communication patterns which could contribute to poor performance were observed in 63% of the surgeries, categorized as communication failures (17 events), protests (23 events), and irrelevant conversations (164 events). The anesthesiologists and the circulating nurses had the most concerning communication patterns. The failure of devices and poor planning were important factors that contributed to concerning patterns.
Conclusion:
Concerning patterns of verbal communication are not rare in operating rooms. Analyzing the annotated transcripts of surgeries can conduce to identifying all these patterns, and their causes. Concerning communication patterns can be reduced in the operating room by providing interventions, properly planning for surgeries, and fixing defective devices.
Application:
The method used in this study can be followed to assess communication problems in operating rooms and to find solutions.
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