Short Communication
Video-Supported Simulation for Interactions in the Operating Theatre (ViSIOT)

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Highlights

  • We introduce a simulation model for improving teamwork during surgery.

  • We address verbal and nonverbal aspects of interactions.

  • We use authentic video footage from the operating theatres in debriefings.

  • The model is grounded in recent research findings.

Abstract

This article introduces a data-grounded simulation model for training social interaction strategies to operating theatre nurses. Video-Supported Simulation for Interactions in the Operating Theatre draws on original video-based research on teamwork in the operating theatres in the United Kingdom. The objective of this model was to improve verbal and nonverbal interactions between nurses and surgeons that often fall outside explicit training. These involve visual monitoring of colleagues, verbal responsiveness, speaking up about distractions, and seeking prompt clarification when needed. The model includes two scenarios and video-supported debriefing, which uses authentic research footage from the operating theatres. In the article, the strategies are briefly communicated and implications for training are discussed.

Section snippets

Video-Supported Simulation for Interactions in the Operating Theatre Model: Translating Research Into Simulation

ViSIOT model (Figure) is a process involving two simulation scenarios (Scenario 1 and Scenario 2) and video-based debriefing. Each component feeds to the next, culminating in new ways of interacting in the final scenario. The progress from Scenario 1 to Scenario 2 illustrates movement from “unsettled” interactions to more “settled” interactions.

Scenario 1

In Scenario 1, the aim is to explore participants' naturally occurring responses to routine-like events. The scenario runs uninterrupted, and any difficulties are allowed to emerge freely. Interactions can flow smoothly or less smoothly depending on how participants act in response to their colleagues. The ViSIOT model has essentially targeted the training of theatre nurses and operating department practitioners (ODPs). Only the participating surgeons and anaesthetists are briefed beforehand.

Interactional Observations: Scenario 1

Table 1 outlines the key observations made in a ViSIOT training session with a group of second-year nurse and ODP students from a health and social care department of a London university. Scenario 1 represented a general elective operation. Nothing dramatic was induced to happen by the surgeon and the anaesthetist. However, a sense of urgency was built into the scenario, for example, when the equipment failed to work or surgical items were not readily available in the theatre (these features

Video-Based Debriefing

During debriefing, the ViSIOT facilitators highlighted the interactional observations made. Attention was drawn to the issues that may had passed unnoticed by the students, such as not verbally responding to colleagues. The authentic but anonymised videos used in the original research were deemed important debriefing material: it is important that participants do not rely on memory and feelings alone when reflecting on the experience and are not embarrassed by watching recordings of their own

Scenario 2

Scenario 2 provided an opportunity to try out the solution strategies and experience new ways of interacting (using the scenario set out in Scenario 1). The objective was to reduce the interactional difficulties that emerged during Scenario 1 (see Table 2).

Implications for Training

The observations suggest that the research findings are directly transferable to training, as similar issues with respect to visual monitoring, clarification, verbal responsiveness, and music were identified in the original research and in the simulation. Clinical educators should respond to the need for detailed interaction training, which has the potential to improve teamwork during real operations. Communication breakdowns, such as silence between team members, have contributed to tragic

Acknowledgments

The authors thank the clinical educators and students who participated in the Video-Supported Simulation for Interactions in the Operating Theatre (ViSIOT) training days. Special thanks to Kathy Nicholson. The model arises from a research project funded by the Economic and Social Research Council (RES-062-23-3219). Currently, the ViSIOT development is funded by the British Academy (PF140002). Preliminary ideas about ViSIOT were presented at the International Nursing Association for Clinical

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