The operating theatre as a classroom: a literature review of medical student learning in the theatre environment

Objectives: We set out to review the published literature relating to the educational experiences of medical students in the operating theatre. In particular, we wished to deduce from the current evidence what challenges are posed to student learning in this environment, and how they may be overcome.

Methods: National Library of Medicine and Google Scholar databases were searched from 1990-2018, using search terms 'Operating Theatre,' OR 'Operating Theater,' OR 'Operating Room' AND 'Medical Students.' Title and abstract review of 679 papers were performed. Full-text English language papers about the learning or satisfaction of medical students in the theatre environment were included. Papers exploring the experiences of residents/trainees rather than medical students were excluded. A total of 36 papers were eligible for inclusion. Thematic analysis was conducted on these papers.

Results: A number of common themes were identified. Throughout the literature, medical students describe a lack of clear learning objectives, fear, anxiety, feelings of humiliation and intimidation, lack of visualisation and lack of opportunity for participation as barriers to their satisfaction with theatre placements and to their subjective learning.

Conclusions: Obstacles identified by students as deleterious to their experiences in the operating theatre are remarkably reproducible across a number of research studies in different populations. Areas to address by both individual educators and curriculum designers include fostering a culture of inclusion in theatre, setting explicit, achievable learning goals for students in this environment and making a concerted effort to prepare students for the theatre setting.