Learning adaptation experiences of circulating nurses in robot-assisted femoral neck fracture surgery from a...

Robot-assisted femoral neck fracture surgery introduces image acquisition, registration, trajectory planning, robotic-arm positioning and device troubleshooting into the operating room workflow, but little is known about how circulating nurses adapt to these tasks. This study explored the learning adaptation experiences, key difficulties, capability transitions and training needs of circulating nurses involved in robot-assisted femoral neck fracture surgery. A descriptive phenomenological design was used. Purposeful maximum-variation sampling was adopted to recruit 12 operating room nurses who had participated in robot-assisted femoral neck fracture surgery. Semi-structured face-to-face interviews were conducted, audio-recorded and transcribed verbatim. Data were analysed using Colaizzi's seven-step method. Reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Five themes and 13 subthemes were identified: initial experiences combining technological unfamiliarity and safety pressure; key operational links as the main bottlenecks in the learning curve; capability transition from passive execution to proactive anticipation; reshaping of the circulating nurse's communication role within the robotic team; and prominent needs for standardized training and access management. The learning adaptation of circulating nurses in robot-assisted femoral neck fracture surgery is staged and multidimensional. Early learning is characterized by technical unfamiliarity, safety pressure and limited confidence in troubleshooting. With experience, nurses develop workflow anticipation, risk identification and multidisciplinary coordination capabilities. A staged training, simulation, case-review and competency-access system is recommended to improve nursing consistency and surgical safety.