How Do Early Emotional Experiences in the Operating Theatre Influence Medical Student Learning in This Environment?

Background: The emotions experienced by medical students on first exposure to the operating theatre are unknown. It is also unclear what influence these emotions have on the learning process. Purposes: To understand the emotions experienced by students when in the operating theatre for the first time and the impact of these emotions on learning. Methods: Nine 3rd-year medical students participated in semistructured interviews to explore these themes. A qualitative approach was used; interviews were transcribed and coded thematically. Results: All participants reported initial negative emotions (apprehension, anxiety, fear, shame, overwhelmed), with excitement being reported by 3. Six participants considered that their anxiety was so overwhelming that it was detrimental to their learning. Participants described a period of familiarization to the environment, after which learning was facilitated. Early learning experiences centered around adjustment to the physical environment of the operating theatre. Factors driving initial negative feelings were loss of familiarity, organizational issues, concerns about violating protocol, and a fear of syncope. Participants considered that it took a median of 1 week (range = 1day-3 weeks) or 5 visits to the operating theatre (range = 1-10) before feeling comfortable in the new setting. Emotions experienced on subsequent visits to the operating theatre were predominantly positive (enjoyment, happiness, confident, involved, pride). Two participants reported negative feelings related to social exclusion. Being included in the team was a powerful determinant of enjoyment. Conclusions: These findings indicate that for learning in the operating theatre to be effective, addressing the negative emotions of the students might be beneficial. This could be achieved by a formal orientation program for both learners and tutors in advance of attendance in the operating theatre. For learning to be optimized, students must feel a sense of inclusion in the theatre community of practice.