Overlapping surgery (OS) occurs when a single surgeon is concurrently caring for patients in multiple operating rooms (OR) but is present for all critical portions of each surgery. Although this is common practice, most studies have found public disapproval of OS. This study aims to better understand attitudes toward OS of patients who gave informed consent for OS.
Participant interviews covered topics including trust, OR personnel roles, and attitudes toward OS. Four representative transcripts were distributed among researchers for independent code identification. These were aggregated into a codebook, applied by two coders. Iterative and emergent thematic analyses were done.
Twelve participants were interviewed to reach thematic saturation. Three themes shaped how participants felt about OS: trust in their surgeon, worries about OS, and understanding of OR personnel roles. Factors contributing to trust included personal research and the surgeon's experience. Frequently cited concerns were unpredictability of complications during operations and the surgeon's divided attention. Two participants inaccurately understood personnel roles, believing the surgeon did most or all the hands-on work while trainees were observers. Most participants felt a high or neutral level of comfort toward OS and indicated trust as the reason.
In contrast to prior research, this study found that most participants had a neutral or positive view of OS. This suggests that a trusting relationship with their surgeon and informed consent are important factors in increasing comfort for OS. Participants who misunderstood OR roles felt less comfortable toward OS. This highlights an opportunity for patient education on trainee roles.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Surgical Research
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Statements on principles. American College of Surgeons. Published 1974.(Available at:)https://www.facs.org/about-acs/statements/stonprinDate: 2016Date accessed: December 20, 2021
- Association of overlapping surgery with perioperative outcomes.JAMA. 2019; 321: 762-772
- Overlapping surgery increases operating room efficiency without adversely affecting outcomes in total hip and knee arthroplasty.J Arthroplasty. 2020; 35: 1529-1533.e1
- Safety of overlapping surgery at a high-volume referral center.Ann Surg. 2017; 265: 639-644
- Safety of overlapping inpatient orthopaedic surgery: a multicenter study.J Bone Joint Surg Am. 2018; 100: 1902-1911
- Clash in the name of care. The Boston Globe.(Available at:)https://apps.bostonglobe.com/spotlight/clash-in-the-name-of-care/story/Date: 2015Date accessed: July 6, 2022
- Public perceptions of overlapping surgery.J Am Coll Surg. 2017; 224: 771-778.e4
- A survey of overlapping surgery policies at U.S. Hospitals.J Law Med Ethics. 2021; 49: 64-73
- What is an adequate sample size? Operationalising data saturation for theory- driven interview studies.Psychol Health. 2010; 25: 1229-1245
- Constructing Grounded Theory: A Practical Guide Through Qualitative Analysis.Sage Publications, London2006
- Handbook for Team-Based Qualitative Research.AltaMira Press, Lanham, MD2007
- Coding in-depth semistructured interviews: problems of unitization and intercoder reliability and agreement.Social Methods Res. 2013; 42: 294-320
- Intercoder reliability in qualitative research: debates and practical guidelines.Int J Qual Methods. 2020; 19https://doi.org/10.1177/1609406919899220
- Patient perceptions of trust in trainees during delivery of surgical care: a thematic analysis.J Surg Educ. 2021; 78: 462-468
- Patient opinions regarding surgeon presence, trainee participation, and overlapping surgery.Laryngoscope. 2019; 129: 1337-1346
- Trust as a predictor of patient perceptions regarding overlapping surgery and trainee independence.Laryngoscope. 2020; 130: 2728-2735
- Do the patients read the informed consent?.Balkan Med J. 2014; 31: 132-136
- The reality of informed consent: empirical studies on patient comprehension-systematic review.Trials. 2021; 22: 57
Published online: February 15, 2023
Accepted: October 16, 2022
Received in revised form: September 11, 2022
Received: March 21, 2022
© 2022 Published by Elsevier Inc.