Barn theatres: A novel learning environment for orthopaedic surgeons

Barn-integrated operating rooms represent an emerging model in surgical education, offering open-plan layouts designed to enhance efficiency and learning. Despite growing use across United Kingdom centres, limited data exist on their impact on surgical training. This primary aim of this study is to explore the perceived benefits and challenges of barn-integrated operating rooms among orthopaedic surgeons in the context of the multidisciplinary team.

A prospective mixed-methods study was conducted using a pilot-tested questionnaire distributed to 93 orthopaedic theatre personnel, including consultant and trainee orthopaedic surgeons, operating department practitioners, and scrub nurses, assessing satisfaction, supervision, and educational value.

Of 54 respondents (58% response rate), 81.5% preferred barn-integrated operating rooms to conventional theatres. Of the total, 78.3% of surgeons reported visiting adjacent barn-integrated operating rooms theatres for learning, and 67.4% agreed supervision was superior. Thematic analysis revealed improved accountability, communication, and support. Concerns included potential infection risk (33%), radiation exposure (33%), and noise disturbance (46%).

Barn-integrated operating rooms provide a promising environment for surgical training, promoting supervision, learning frequency, and teamwork. Addressing perceived risks through structured safety protocols will be essential as adoption expands. Further multicentre research is warranted to evaluate long-term outcomes. Findings should be interpreted within the constraint that perspectives were limited predominantly to surgeons.