Perceptions about perioperative communication among anesthesiologists and surgeons and the impact of perceived status hierarchies on teamwork in the operating room

This exploratory study examines anesthesiologists' and surgeons' perceptions regarding perioperative communication and the extent to which any differences or barriers to effective communication are a function of a perceived power dynamic and/or occupational status hierarchies between them. Semi-structured interviews were conducted with 11 attending anesthesiologists and 10 attending surgeons actively practicing clinically in the United States to explore their perceptions about perioperative communication, status hierarchies in the medical profession, and effective teamwork. The interviews were analyzed using Interpretative Phenomenological Analysis to identify recurrent and overarching themes. Both groups acknowledged the role of effective perioperative communication in ensuring optimal surgical outcomes and identified factors such as team inconsistencies and lack of familiarity with the team as major barriers to effective teamwork. Multiple other occupational and institutional barriers were identified. Both clinician groups alluded to a perceived hierarchy in certain contexts, which can impact expectations and communication dynamics within the operating room environment. This appears to be a nuanced and complex relationship which is manifested via several indirect pathways. There are multiple cultural, occupational, and institutional factors that impact the quality of perioperative communication between anesthesiologists and surgeons. The mechanisms by which perceptions around occupational status hierarchies act as a barrier to effective communication appear to be indirect, complex, and warrant further exploration.