Communication in the operating theatre

A realist process evaluation of robot-assisted surgery: integration into routine practice and impacts on communication, collaboration and decision-making

“…25 What these studies do not provide is a consideration of the non-verbal co-ordination that has been shown to be an important aspect of teamwork in the OT or of the strategies the OT team employs to manage the differences in communication and teamwork. 28,29 Neither do they explore the additional contextual factors beyond the technology that affect communication and teamwork.…”

“…67 Existing studies point to the significance of non-verbal communication in the OT, and the tacit nature of the knowledge that underlies such practices means that it is rarely revealed through interview studies. 29 We selected OTAS, a structured observation tool, for assessing teamwork in the operations we observed. 68 We chose to use OTAS rather than other non-technical evaluation tools related to surgery, such as NOTSS (Non Technical Skills for Surgeons), because, first, it considers the teamwork skills of all professional groups within the OT 69 and, second, it considers, and provides separate ratings for, team behaviours that seemed particularly relevant to testing our candidate theories, such as team monitoring and situational awareness.…”

“…[73][74][75] The value of video recordings is that they capture not only oral communication but also non-verbal communication, such as gesture, gaze and tool manipulation, that has been shown to be important for teamwork in the OT. 29,76 Another benefit of video recordings is that they are permanent, allowing for repeated analysis. They also facilitate collaborative analysis.…”

Embedding robotic surgery into routine practice and impacts on communication and decision making: a review of the experience of surgical teams

“…There is a perception that, if the team does not respond in this way, communication is compromised (Fung and Aly 2013;Huettner et al 2010). A consequence of this may be a further increase in operation duration, as an observational study of 160 surgical procedures found communication failure to be a significant predictor of deviation in expected length of operation (Gillespie et al 2012 (Bezemer et al 2011;Weldon et al 2013). To better understand why these communication challenges occur, it is important to remember that communication is a complex multilayered representation, combining physical artefacts, gesture, and speech, where no single layer is complete or coherent by itself (Hutchins and Palen 1997).…”

“…One recommendation is to focus on those theories that are cited in the individual studies that are retrieved (Booth et al 2013). Given the absence of such reference to theory within the papers we had retrieved, we instead took the approach of seeking out reviews of literature in the areas of implementation science (Greenhalgh et al 2004;Nilsen 2015;Robert et al 2010), communication (Manojlovich et al 2015;Weldon et al 2013) and teamwork (Manser 2009;Paris et al 2000;Rousseau et al 2006;Sims et al 2015;Xiao et al 2013), and decision making (Mosier and Fischer 2010;Patel and Kannampallil 2015;Patel et al 2013). In identifying theories concerning implementation, we specifically sought out theories that relate to interventions whose effective implementation is dependent on use not by individuals but by a group and, similarly, in identifying theories concerning decision making we specifically sought out theories that consider how information is shared and decisions are made within a group, rather than those which focus on individual cognition.…”