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World J Surg. 2018 Jul;42(7):2011-2017. doi: 10.1007/s00268-017-4442-4.

More Than Talking About the Weekend: Content of Case-Irrelevant Communication Within the OR Team.

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Department of Visceral Surgery and Medicine, University Hospital of Bern, 3010, Bern, Switzerland.
University of Neuchâtel, Institute of Work and Organizational Psychology, Neuchâtel, Switzerland.
Department of Psychology, University of Berne, Bern, Switzerland.
Department of Visceral Surgery and Medicine, University Hospital of Bern, 3010, Bern, Switzerland.



Case-irrelevant communication (CIC) is defined as "any conversation" irrelevant to the case. It includes small talk, but also communication related to other work issues besides the actual task. CIC during surgeries is generally seen as distracting, despite a lack of knowledge about the content of CIC and its regulation in terms of adjustments to the situation of CIC. Primary goal of the study was to evaluate CIC content; secondary goal was to evaluate whether surgical teams regulate CIC according to different concentration demands of surgical procedures.


In 125 surgeries, 1396 CIC events were observed. CIC were content coded into work-related CIC (pertaining to other tasks or work in general) and social CIC (pertaining to acquaintance talk, gossip, or private conversation). The impact of different phases and the difficulty of the surgical procedure on CIC were assessed.


Work-related CIC were significantly more frequent (2.49 per hour, SD = 2.17) than social CIC (1.42 per hour, SD = 2.17). Across phases, frequency of work-related CIC was constant, whereas social CIC increased significantly across phases. In surgeries assessed as highly difficult by the surgeons, social CIC were observed at a lower frequency, and less work-related CIC were observed during the main phase compared to surgeries assessed as less difficult.


The high proportion of work-related CIC indicates that surgical teams deal with other tasks during surgeries. Surgical teams adapt CIC according to the demands of the procedure. Hospital policies should support these adaptations rather than attempt to suppress CIC entirely.

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