title: Disagreement and aggression in the operating theatre.
abstract: OBJECTIVE
  This paper is a report of a study to determine the national spread of incidents of disagreement within and between professional groups in operating departments and the frequency of perceived aggressive behaviour demonstrated by operating department personnel.
  
  
  BACKGROUND
  There is both anecdotal and empirical evidence supporting the idea of the operating team as the ultimate example of teamworking in health care. At the same time, international concern is expressed over the level of interprofessional conflict and aggression reported in operating departments. Such reports do not sit well with notions of excellence in teamwork as conceptualized by theorists.
  
  
  METHODS
  A questionnaire survey was designed, and sent to a random sample of National Health Service operating departments in England (n = 62) in 2002. Usable survey questionnaires were returned from 37 departments (response rate 59.6) and yielded 391 individual responses. Respondents included nurses (58%, n = 227), surgeons (9.7%, n = 38), anaesthetists (14.32%, n = 56) and operating department practitioners (17.9%, n = 70) of all grades.
  
  
  RESULTS
  Half of the respondents reported experiencing aggressive behaviour from consultant surgeons (53.4%, n = 209). Daily disagreements between nurses and consultants about list management were reported. Perceptions of lack of understanding of roles and shared goals for patient care between the professional groups were also reported. Similar reports were received from all geographical locations in the sample.
  
  
  CONCLUSIONS
  Further research is needed to conceptualize the complex nature of interprofessional working in operating theatres before steps can be taken to develop a less stressful and more efficient working environment.
authors.affiliation: University College Hospital, London, UK. richard.coe@uclh.nhs.uk
authors.forename: Richard
authors.initials: R
authors.lastname: Coe
authors.forename: Dinah
authors.initials: D
authors.lastname: Gould
mesh_terms: D000374:Aggression; D000776:Anesthesiology; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D034462:Dissent and Disputes; D004739:England; D013502:General Surgery; D006801:Humans; D007400:Interprofessional Relations; D009872:Operating Room Technicians; D009873:Operating Rooms; D010348:Patient Care Team; D013527:Perioperative Nursing