Critical thinking in the operating theatre

We know very little about the cognitive skills used by clinicians in the operating theatre. The critical thinking of expert surgeons and anaesthetists has rarely been studied. In this article, we examine the methods that have been used, both in simulators and in vivo, to study critical thinking of operating theatre team members, such as surgeons and anaesthetists. With difficulties in access to expert practitioners and in implementing control conditions, key methods are principally qualitative in nature and include observations 'in the wild' and in simulation, verbal protocol analysis in simulation, and retrospective interviews. A brief review of such studies suggests that critical thinking in the operating theatre involves not only decision making, as one would expect, but also situation awareness, risk assessment and communication skills.