Related Experiment Video
Updated: Jan 11, 2026
Emergency Undocking in Robotic Surgery: A Simulation Curriculum
Published on: May 20, 2018
Too Loud to Learn? Communication Barriers, Psychological Safety, and Learning in the Operating Room
Sarah E Hughes1, Eunice Y Lee2, Andrew S Bolze1
1University of Michigan Medical School, Ann Arbor, Michigan.
Objective:
To assess how medical students experience communication challenges in the operating room (OR), and how these barriers affect psychological safety.
Design:
Cross-sectional, anonymous survey study.
Setting:
A single academic medical center in the United States.
Participants:
Eighty-three medical students who had completed a surgical clerkship and reported OR experience.
Results:
The majority (73/83, 88.0%) reported difficulty hearing in the OR. Greater hearing difficulty was associated with lower psychological safety (ρ = -0.46, p < 0.001), especially with hierarchy (ρ = -0.44) and comfort seeking clarification (ρ = -0.42). Over two-thirds (68.7%) said hearing difficulty impaired their learning. Nearly 74% reported reduced confidence or sense of belonging. Thematic analysis of free-text responses revealed 7 themes, including fear of judgment, missed opportunities, and concern about career fit.
Conclusions:
Hearing-related communication barriers in the OR are common among medical students and are linked to reduced psychological safety, confidence, and learning. These findings suggest a need for structural and interpersonal changes to promote accessible, inclusive surgical education.
Related Concept Videos
01:21Barriers to Effective Communication II
Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
As a result of their tendency to use...
01:08Obedience
01:30Barriers to Effective Communication I
Communication barriers include the following:
Physiological barriers: They are limitations caused by a person's health condition or disability, such as hearing loss, poor eyesight, illness, or unconsciousness. An example to overcome this...
01:30Psychosurgery
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
01:29SBAR I: Understanding the Concept
Standardized methods of communication have been developed to ensure that information is...
01:15Techniques of therapeutic communication I: Active Listening, Sharing Observations, Validation, and Using Touch
Therapeutic communication is not the same as social interaction. Social interaction has no goal or purpose and consists of casual information sharing, whereas therapeutic communication has a plan or purpose for the conversation. Therapeutic...