Aim: To identify examples of surgeons good and poor intraoperative behaviours related to safe
and efficient surgery.
Methods: Ten observations will undertaken in the operating theatres of Rigshospitalet and
Herlev Hospital with the researchers taking field notes. This provides the Ph.d student with
empirical background knowledge of observed surgical behaviour as well as an understanding of
surgical culture. The knowledge will be used to qualify the interviewguide.
8 semi-structured group interviews and 3 individual interviews will be conducted and tape
recorded. The interviews will be led by the Ph.d student with an anesthesia nurse present as
a co-moderator. The groups will contain 4 - 12 participants.
The interview guide will be developed with a Scottish behavioural marker system as a
framework, drawing upon the literature as well as the observations. It will contain questions
regarding leadership, communication, teamwork, situation awareness and decision making to
facilitate a discussion about surgeons' good and poor behaviours.
Material: Data will be collected in two hospitals in the capital Region of Denmark,
Rigshospitalet and Herlev Hospital. Each hospital will provide four focus groups, one
containing consultant surgeons in general surgery, one trainee surgeons, one scrub nurses and
one containing a mixture of anesthetists and anesthesia nurses. The two latter focus groups
is included to get the perspectives of the surgeons' team members since international studies
have demonstrated differences of opinion regarding the perceived quality of teamwork amongst
operating theatre staff. This study will be the first to build in the opinions of the team
members into a behavioural marker system. 3 individual interviews with surgeons will
afterwards conducted in one of the hospitals to get a more in-depth discussion.
Data analysis and statistics: The interviews will be fully transcribed and analysed using
qualitative method of systematic text condensation. Power calculations are not relevant in
this qualitative study. Accepted guidelines state that the number of participants in each
group should range between 5 and 15 and the data are from two large university hospitals
receiving different patient categories to ensure a certain representative sample of