Massachusetts Chapter of the American College of Surgeons

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Quantitative Measures of Teamwork in the OR Reveal an Unexpected Gender Bias
Nicholas Jonas, Darlene Bourgeois, Tasneem Zaihra, Deanna Plewa, Zoe Nepomnayshy, Haleila Harrison, Johanna Matulonis, Augustus Gleason, Dmitry Nepomnayshy
Lahey Hospital and Medical Center, Burlington, MA

Introduction: Historically, operating room (OR) teamwork was measured by self-assessment or direct observation. This study’s goal was to assess the validity of the TeamSTEPPSTM questionnaire (T-TPQ) compared to direct observation of teamwork in the OR.
Methods: Operations were objectively assessed using a modified binary version of the Observational Teamwork Assessment for Surgery (OTAS) by trained observers. Simultaneously, the OR staff completed a T-TPQ. Subgroups of the OTAS and T-TPQ were compared using Welch’s t-test.
Results: OTAS Quantitative Results 58 complete surgical cases were assessed. The highest domain was Leadership (score of 95%), and the lowest was Situational Monitoring (score of 41%). On subgroup analysis, within the Cooperation domain, OR staff (nursing and anesthesia) provided fewer updates to female surgeons than male (65% vs 84%, p=<0.05). TTPQ Questionnaire Results 86 surveys were completed (39 surgeons, 21 anesthesiologists, 26 nurses/technicians); a 42% survey completion rate. Communication domain scored the highest (score of 78%) while Team Function scored the lowest (score of 68%). Subgroup analysis showed there were no differences in perceptions of teamwork for males versus females.
Conclusions: We demonstrated validity of the T-TPQ survey by showing correlation to the OTAS tool. Intraoperative gender bias was unexpectedly but directly observed: fewer updates from the OR team to female versus male surgeons – a critical area of future study.


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