Discrepant perceptions of communication, teamwork and situation awareness among surgical team members

Int J Qual Health Care. 2011 Apr;23(2):159-66. doi: 10.1093/intqhc/mzq079. Epub 2011 Jan 17.


Objective: To assess surgical team members' differences in perception of non-technical skills.

Design: Questionnaire design.

Setting: Operating theatres (OTs) at one university hospital, three teaching hospitals and one general hospital in the Netherlands.

Participants: Sixty-six surgeons, 97 OT nurses, 18 anaesthetists and 40 nurse anaesthetists.

Methods: All surgical team members, of five hospitals, were asked to complete a questionnaire and state their opinion on the current state of communication, teamwork and situation awareness at the OT.

Results: Ratings for 'communication' were significantly different, particularly between surgeons and all other team members (P ≤ 0.001). The ratings for 'teamwork' differed significantly between all team members (P ≤ 0.005). Within 'situation awareness' significant differences were mainly observed for 'gathering information' between surgeons and other team members (P < 0.001). Finally, 72-90% of anaesthetists, OT nurses and nurse anaesthetists rated routine team briefings and debriefings as inadequate.

Conclusions: This study shows discrepancies on many aspects in perception between surgeons and other surgical team members concerning communication, teamwork and situation awareness. Future research needs to ascertain whether these discrepancies are linked to greater risk of adverse events or to process as well as systems failures. Establishing this link would support implementation and use of complex team interventions that intervene at multiple levels of the healthcare system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anesthesiology
  • Attitude of Health Personnel*
  • Awareness
  • Hospitals
  • Humans
  • Interdisciplinary Communication*
  • Netherlands
  • Nursing Staff, Hospital
  • Operating Rooms
  • Patient Care Team / organization & administration
  • Patient Care Team / standards*
  • Physician-Nurse Relations
  • Surgical Procedures, Operative / standards*
  • Surveys and Questionnaires
  • Workforce