Operating theatre human factors questionnaire

Author of Tool: 

O’Connor, Keogh, & Ryan

Key references: 

O'Connor, P., Keogh, I., & Ryan, S. (in press). A comparison of the teamwork attitudes and knowledge of Irish surgeons and U.S. Naval aviators. Surgeon. http://www.sciencedirect.com/science/article/pii/S1479666X11001247

Primary use / Purpose: 

To allow an assessment of the attitudes and knowledge of surgeons to various aspects of human factors and teamworking


The Operating Theatre human factors questionnaire is based upon the Naval Aviator Human Factors Questionnaire and a human factors knowledge questionnaire designed for U.S Naval aviation (also listed in MIDSS).

The questionnaire consists of 23 attitude items, and eight knowledge questions. The attitude items are divided into four scales: 'my stress’ (the consideration of, and possible compensation for, stressors in oneself), ‘stress of others’ (the consideration of, and possible compensation for, stressors in other team members), ‘communication ‘(encompasses communication of intent and plans, delegation of tasks and assignment of responsibilities, and the monitoring of team members), and ‘command responsibility’ (appropriate leadership and its implications for the delegation of tasks and responsibilities. Three further attitude items were included that to obtain information on whether junior personnel were afraid to speak up to more senior personnel, and whether adequate pre- and post-operative team briefs were conducted (the latter two questions were only asked of the surgeons).

The eight item multiple-choice knowledge test was developed to address teamwork issues that have been identified as causal to accidents in aviation (situation awareness, decision making, communication, stress, and fatigue). However, as described in the introduction, these teamwork issues also contribute to poor performance and sentinel events in a surgical environments. As the questionnaire was initially developed for use with naval aviators, two surgeons checked, and where necessary adapted, the language so that it was not aviation specific (e.g. aircrew was changed to team member).


The internal consistency of the attitude survey subscales was found to be comparable to that of questionnaires of this type (the Cronbach’s alpha scores for the surgeon sample ranged from 0.41 to 0.66).



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