Lowering communication barriers in operating room technology

Objectives: This paper examines the effects of new technology on team communication and information flow in a complex work environment, and offers design suggestions for improved team performance. Background: Case study of a robot-assisted cholecystectomy procedure revealed teamwork disruption and an increase in the complexity of information flow and communication in the operating room as a result of the novel technology. A controlled experiment using a between-subjects design was conducted to test the hypothesis that providing critical information in a timely and accessible manner would increase communication efficiency and reduce errors in task performance. Methods: Eighteen pairs of participants took part in a simulated tool-changing task in surgery under one of three communication conditions: (a) no rules, (b) scripted, or (c) automated. Results: Teams in the scripted and automated conditions performed significantly faster than the no-rules teams (p <.05). Teams in the automated condition made significantly more errors than those in the scripted condition (p <.05). Conclusion: Scripted speech can facilitate team communication and adaptation to new technology; automatic information display interfaces are not useful if the modality is incompatible with operator expectations. Application: Information displays and communication protocols can be designed to ease adaptation to complex operating room technology.