Evidence map›Paper›PMID 31830122›Full record

Observational studyPloS one2019

"Disruptive behavior" in the operating room: A prospective observational study of triggers and effects of tense communication episodes in surgical teams.

Sandra Keller, Franziska Tschan, Norbert K Semmer, Eliane Timm-Holzer, Jasmin Zimmermann, Daniel Candinas, Nicolas Demartines, Martin Hübner, Guido Beldi

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
13.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Alone Together: Is Strain Experienced Concurrently by Members of Operating Room Teams?: An Event-based Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023
    Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 2 countries.

Sandra KellerInstitute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.ORCID 0000-0003-3229-9003
Franziska TschanInstitute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
Norbert K SemmerInstitute of Work Psychology, University of Bern, Bern, Switzerland.
Eliane Timm-HolzerInstitute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
Jasmin ZimmermannInstitute of Work and Organizational Psychology, University of Neuchâtel, Neuchâtel, Switzerland.
Daniel CandinasDepartment of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland.
Nicolas DemartinesDepartment of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.
Martin HübnerDepartment of Visceral Surgery, Lausanne University Hospital CHUV, Lausanne, Switzerland.
Guido BeldiDepartment of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland.
University of Neuchâtel · CHUniversity Hospital of Bern · CHUniversity of Lausanne · CHUniversity of Bern · CH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTense communication and disruptive behaviors during surgery have often been attributed to surgeons' personality or hierarchies, while situational triggers for tense communication were neglected. Goals of this study were to assess situational triggers of tense communication in the operating room and to assess its impact on collaboration quality within the surgical team. METHODS AND

findingsThe prospective observational study was performed in two university hospitals in Europe. Trained external observers assessed communication in 137 elective abdominal operations led by 30 different main surgeons. Objective observations were related to perceived collaboration quality by all members of the surgical team. A total of 340 tense communication episodes were observed (= 0.57 per hour); mean tensions in surgeries with tensions was 1.21 per hour. Individual surgeons accounted for 24% of the variation in tensions, while situational aspects accounted for 76% of variation. A total of 72% of tensions were triggered by coordination problems; 21.2% by task-related problems and 9.1% by other issues. More tensions were related to lower perceived teamwork quality for all team members except main surgeons. Coordination-triggered tensions significantly lowered teamwork quality for second surgeons, scrub technicians and circulators.

conclusionsAlthough individual surgeons differ in their tense communication, situational aspects during the operation had a much more important influence on the occurrence of tensions, mostly triggered by coordination problems. Because tensions negatively impact team collaboration, surgical teams may profit from improving collaboration, for instance through training, or through reflexivity.

Indexed as

CommunicationInterprofessional RelationsProblem BehaviorClinical CompetenceHumansOperating RoomsPatient Care TeamProspective StudiesSurgeonsSurgical Procedures, Operative

Identifiers

PMID31830122
PMCPMC6907803
OpenAlexW2995600888

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.