Rarani Saeid Amini
Student Research Committee, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Patient Saf Surg. 2025 Sep 2;19(1):23. doi: 10.1186/s13037-025-00448-w.
In the high-stakes environment of the operating room (OR), patient safety depends not only on technical expertise but also on seamless communication, clear roles, and coordinated teamwork. Traditional approaches often overlook the relational and performative dimensions of surgical care.
This narrative article proposes a metaphorical framework that compares surgical practice to live theater, where each team member plays a rehearsed role, and protocols act as scripts. The study explores key themes such as preparation (rehearsals), intraoperative coordination (live performance), and structured debriefing (curtain call). The aim is to synthesize knowledge from clinical literature and human factors theory to provide a novel interpretive framework for improving patient safety in the operating room (OR). A selective literature review was conducted focusing on peer-reviewed publications related to surgical teamwork, communication, safety checklists, and non-technical skills. Sources were identified through PubMed and Google Scholar using relevant terms such as "surgical safety," "human factors in surgery," and "team communication."
The metaphorical framework reveals that each member of the OR team-from the surgeon to the scrub nurse-is reimagined as a theatrical role, with their contribution being essential to the surgical outcome. Key concepts such as simulation training, checklists, psychological safety, and mutual accountability are highlighted as critical tools for enhancing performance and reducing preventable harm. The study emphasizes the importance of clear role definitions, team coordination, and continuous learning, similar to a theater production's preparation, performance, and reflection stages.
Viewing the OR through the lens of theater offers a novel, human-centered model for improving surgical safety. This conceptual framework promotes structured teamwork, shared mental models, and a culture where every action is intentional and every role is respected ensuring that each surgical performance prioritizes the patient's well-being above all.
在手术室这种高风险环境中，患者安全不仅取决于技术专长，还取决于无缝沟通、明确的角色和协调的团队合作。传统方法往往忽视了外科护理中的关系维度和实践维度。
这篇叙述性文章提出了一个隐喻框架，将外科手术实践比作现场戏剧表演，其中每个团队成员都扮演一个经过排练的角色，而规程则充当剧本。该研究探讨了诸如准备（排练）、术中协调（现场表演）和结构化汇报（谢幕）等关键主题。目的是综合临床文献和人为因素理论中的知识，为提高手术室患者安全提供一个新颖的解释框架。进行了一项选择性文献综述，重点关注与外科团队合作、沟通、安全检查表和非技术技能相关的同行评审出版物。通过使用“手术安全”、“手术中的人为因素”和“团队沟通”等相关术语，在PubMed和谷歌学术搜索中确定了资料来源。
该隐喻框架表明，手术室团队的每个成员——从外科医生到洗手护士——都被重新想象为一个戏剧角色，他们的贡献对手术结果至关重要。模拟培训、检查表、心理安全和相互问责等关键概念被强调为提高绩效和减少可预防伤害的关键工具。该研究强调了明确角色定义、团队协调和持续学习的重要性，这类似于戏剧制作的准备、表演和反思阶段。
从戏剧的角度看待手术室提供了一个新颖的、以人为主的提高手术安全的模式。这个概念框架促进了结构化团队合作、共享心智模式以及一种每个行动都有目的且每个角色都受到尊重的文化，确保每次手术都将患者的福祉置于首位。
