Department of Psychology, Emory University, Atlanta, GA 30322;
Center for Research and Evaluation, Kaiser Permanente Georgia, Atlanta, GA 30305.
Proc Natl Acad Sci U S A. 2018 Jul 17;115(29):7575-7580. doi: 10.1073/pnas.1716883115. Epub 2018 Jul 2.
Operating rooms (ORs) are inhabited by hierarchical, mixed-gender clinical teams that are often prone to conflict. In evolutionary terms, one expects more within- than between-gender rivalries, especially since the OR is a place where all sorts of social interactions occur, not merely technical communications. To document the full range of behavior, the present study used ethological observation techniques, recording live all social behavior by the team. Using an ethogram, 6,348 spontaneous social interactions and nontechnical communications were timestamped during 200 surgical procedures. Cooperation sequences (59.0%) were more frequent than conflict sequences (2.8%), which ranged from constructive differences of opinion to discord and distraction that could jeopardize patient safety. Behavior varied by clinical role and with the gender composition in the OR. Conflict was initiated mostly down the hierarchy between individuals several ranks apart. Cooperation tended to increase with a rising proportion of females in the OR, but the most pronounced effect concerned the interaction between both genders. If the attending surgeon's gender differed from that of the majority of other personnel in the OR, cooperation was significantly more common.
手术室（OR）中存在着等级分明、男女混合的临床团队，这些团队往往容易发生冲突。从进化的角度来看，人们期望更多的是同性别之间的竞争，而不是不同性别之间的竞争，尤其是因为手术室是一个发生各种社交互动的地方，而不仅仅是技术交流。为了记录所有的行为，本研究使用了行为观察技术，实时记录了团队的所有社交行为。通过使用行为谱，在 200 例手术过程中对 6348 次自发的社交互动和非技术交流进行了时间标记。合作序列（59.0%）比冲突序列（2.8%）更频繁，冲突序列从建设性的意见分歧到不和谐和分心，可能危及患者安全。行为因临床角色和手术室中的性别构成而异。冲突主要是由相差几个等级的个体在等级结构中发起的。随着手术室中女性比例的上升，合作的趋势也在增加，但最显著的影响涉及到两种性别的相互作用。如果主治外科医生的性别与手术室中大多数其他人员的性别不同，那么合作就会明显更加频繁。
