Too Loud to Learn? Communication Barriers, Psychological Safety, and Learning in the Operating Room
Year: 2025
Type: article
Study design: Observational Study
Abstract: • 88% of students reported difficulty hearing in the OR environment. • Hearing difficulty significantly correlated with lower psychological safety. • Communication barriers limited learning, confidence, and participation. • Students described missed opportunities and fear of poor evaluations. • Findings reveal an overlooked, addressable barrier in surgical education. To assess how medical students experience communication challenges in the operating room (OR), and how these barriers affect psychological safety. Cross-sectional, anonymous survey study. A single academic medical center in the United States. Eighty-three medical students who had completed a surgical clerkship and reported OR experience. The majority (73/83, 88.0%) reported difficulty hearing in the OR. Greater hearing difficulty was associated with lower psychological safety (ρ = –0.46, p < 0.001), especially with hierarchy (ρ = –0.44) and comfort seeking clarification (ρ = –0.42). Over two-thirds (68.7%) said hearing difficulty impaired their learning. Nearly 74% reported reduced confidence or sense of belonging. Thematic analysis of free-text responses revealed 7 themes, including fear of judgment, missed opportunities, and concern about career fit. Hearing-related communication barriers in the OR are common among medical students and are linked to reduced psychological safety, confidence, and learning. These findings suggest a need for structural and interpersonal changes to promote accessible, inclusive surgical education.
Source: Journal of surgical education
Institutions: University of Michigan, Michigan Medicine
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,420
OpenAlex ID: W4416028872