Surgeons Rate Last in Operating Room

A study based on a survey measuring attitudes toward the work environment in the operating room (OR) reveals that surgeons exhibit the lowest level of teamwork and nurses the highest.

The survey, called the Safety Attitudes Questionnaire (SAQ), was developed by a team at The Johns Hopkins University School of Medicine (Baltimore, MD, USA). The SAQ contains 65 questions in six areas relating to safety, including teamwork climate, safety climate, job satisfaction, perceptions of management, stress recognition, and working conditions. The SAQ questionnaires were presented to all OR caregivers in a Catholic health system comprising 60 hospitals in 16 states during July and August 2004. On each question on teamwork, participants were asked to rate themselves and their peer groups on a scale of 1 to 5. The overall response rate was 77.1%.

Only 65% of OR personnel thought surgeons exhibited a high or very high level of teamwork, compared to 83.5% for general surgical nurses, and 85% for certified registered nurse anesthetists (CRNAs). Anesthesiologists rated third at 79%. The results appear in the May 2006 issues of the Annals of Surgery and the Journal of the American College of Surgeons.

"The SAQ provides hospitals with an accurate method for rating safety in the OR because it asks frontline caregivers about the OR work environment,” said lead researcher Martin Makary, M.D., M.P.H., an assistant professor in the department of surgery at Johns Hopkins. "The bottom line is, you wouldn't want to fly with a pilot or copilot who wasn't happy with his working environment, and the same applies to the OR.”

The SAQ was adapted from the Flight Management Attitudes Questionnaire (FMAQ) and its predecessor, the Cockpit Management Attitudes Questionnaire (CMAQ), both of which were developed to address accidents in the airline industry.



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John Hopkins University School of Medicine