Communication challenges faced by operating room students in clinical environments: Insights from a qualitative content analysis

Abstract

Background

Effective communication is a crucial non-technical skill in high-pressure clinical environments like operating rooms, impacting patient safety and team coordination. However, operating room students face obstacles in developing these skills during clinical training. This study aimed to explore and provide an in-depth understanding of the contextual and system-level factors shaping communication barriers encountered by operating room students in clinical settings.

Methods

A qualitative study with a conventional content analysis approach was conducted in 2025 among ten undergraduate operating room students from Hamadan University of Medical Sciences, western Iran. Participants were selected through purposive sampling, and recruitment continued until data saturation was achieved. Data were collected through semi-structured interviews and analyzed concurrently using the Graneheim and Lundman method. Trustworthiness was ensured using Guba and Lincoln’s criteria.

Results

The analysis identified five main themes:(1) Intrapersonal barriers (fear of mistakes, low self-esteem, introversion, lack of interest in the clinical environment),(2) Restrictive organizational and hierarchical structures (surgeons’ authoritarianism, hierarchical culture, lack of formal communication channels),(3) Gap between academic training and clinical demands (insufficient communication skills training, exclusive focus on technical skills, lack of structured feedback),(4) Clinical environmental pressures (heavy workload, time constraints, adverse physical and psychological conditions), and (5) Lack of professional support (absence of active clinical instructors, neglect of students’ roles by the healthcare team, scarcity of positive communication role models).

Conclusion

Communication barriers among operating room students are multifaceted, shaped by individual, organizational, educational, and environmental factors. Addressing these challenges requires curriculum revisions, strengthened professional support, and fostering psychologically safe clinical environments.