4 Signs of Surgeons' Inattention in the OR

"It's the routine cases," they quoted one surgeon they observed in their study of this phenomenon. "It's like the...bile duct injuries always happen in easy gall bladders, right? That's what happened here. It was an easy case. We were chatting and obviously not being as diligent as we should have been."

Even in the best of surgeons this sort of rote performance behavior easily can set in. 

In this study, the researchers interviewed 28 surgeons at four academic medical centers and observed five surgeons who specialize in stomach, duodenum, pancreas, liver, biliary tract, and intestine surgical procedures as they operated between 2007 and 2009.

What they discovered was four behaviors the doctors exhibited, either subconsciously or proactively, at rough spots or surprises during the procedures to transition from normal routine to a more "effortful" or "situationally responsive" mode.

Moulton wrote that it's important during training that surgical students and residents recognize these behaviors as moments when they should pay more attention.

"If trainees do not detect the staff surgeon's more subtle transitions or slowing down moments ... they are less likely to appreciate the subtle nuances that require cognitive effort and minor readjustments," she wrote. "This has obvious implications for teaching and training, and may be one reason why some trainees seem to plow through procedures, failing to slow down appropriately."