Title : Barn theatres: A novel learning environment for orthopaedic surgeons
Abstract:
Introduction: The evolving landscape of surgical education has led to the exploration of alternative models for training environments, including the implementation of Barn-Integrated Operating Rooms (BOR). Early evidence suggests BOR improve theatre efficiency whilst maintaining low levels of surgical site infection. Whilst BOR are increasingly utilised as an education tool, there remains paucity of data detailing its effects on surgical learning outcomes and skill acquisition. This study aims to identify, analyse and discuss the current concerns, benefits, and training experience of surgeons and theatre staff operating in this novel learning environment.
Methods: Prospective cohort study, using a mixed qualitative, quantitative methodology. Theatre staff, current and aspiring orthopaedic surgeon satisfaction and perceptions of the educational environment were assessed via a pilot tested questionnaire.
Results: BOR were preferred to the Conventional Operating Room (COR) environment by 81.5% (44/54) of respondents. Per operating session, 78.3% (36/46) of surgeons, including consultants, attended an adjacent theatre within the BOR for a learning opportunity, at least once. Furthermore, 67.4% of surgeons agree that the BOR facilitates a superior environment for supervision. Reflexive thematic analyses of free text answers elicit themes of increased accountability, supervision and improved communications. One third (18/54) of respondents were concerned that infection rates may be higher in the BOR, in addition to having concerns regarding increased ionisation risk between theatres. 46% of participants had concern regarding noise pollution in-between theatres.
Conclusion: BOR are a promising alternative to a traditional theatre learning environment, fostering increased supervision and frequency of learning encounters for surgeons of all grades. With well-defined local protocols, the BOR can facilitate shared decision making and improve interdisciplinary communication. Multidisciplinary team perceptions regarding noise pollution, radiation and infection risk are topical, under-recognised, and indicate that more research is required in this field.
Key Words: Barn Integrated Operating Rooms, Orthopaedic Training
