Developing and Applying a Taxonomy of Communication Behaviours and Contextual Factors in Robotic Surgical Teams: Research Protocol (Preprint)

Abstract

Robotic surgery has been rapidly integrated into surgical practice in the past few decades. The operating theatre setup for robotic surgery is different from the setup for open or laparoscopic surgery such that the operating surgeon sits at a console away from the rest of the surgical team and patient. Communication and team dynamics are altered due to this physical separation and visual barriers imposed by the robotic equipment. Thus, the overarching aim of this project is to examine what comprises effective communication by robotic surgical teams and its contextual factors.

We aim to develop a taxonomy of communication behaviours and contextual factors and apply the taxonomy to observe and train robotic surgical teams. We will also examine patterns of communication behaviours based on gender.

We will conduct semi-structured interviews with robotic surgical team members including the surgeon, assisting surgeon or trainee, bedside or first assistant, nurses, and anaesthesiologists. Participants will represent different disciplines, including urology, general surgery, gynaecology, and have a range of experiences in robotic surgery. We will use a reflexive thematic analysis to analyse the data and develop a preliminary taxonomy of communication behaviours and contextual factors, their descriptions, and examples. Using the preliminary taxonomy, we will observe live robotic surgeries in the Royal College of Surgeons in Ireland (RCSI) affiliated hospitals using event coding. We will observe varying lengths and conditions of robotic surgical procedures to a capture a wide range of communication behaviours and contextual factors and refine the taxonomy. We will conduct data collection in parallel with data analysis such that if we identify a new behaviour in an interview, we will follow up and ask about it in additional interviews and/or observations.

The taxonomy will include a list of actionable communication behaviours, contextual factors, their descriptions, and examples. The results from this project will be used to observe and train surgical teams in a simulated environment to effectively communicate with each other and prevent communication breakdowns. It will also add to the knowledge base on the role of gender in communication in robotic surgery and produce recommendations that can be incorporated into training.

This project will contribute to the improvement of communication skills of surgical teams and the quality and safety of patient care.