This eye picture encourages surgeons to be less rude in theatre

A simple poster of an eye – stuck up with no explanation – is enough to make surgeons more civil, according to a team of Australian scientists.

The researchers found that staff at an Adelaide hospital reported fewer instances of “incivility” after they’d placed images of eyes, accompanied by phrases like ‘Operate with Respect’, in theatres.

They’ve published their findings in PLOS One.

“The idea comes from parts of psychology, where we know that when you’re observed, you behave better,” lead author Professor Cheri Ostroff, a researcher at the University of South Australia, tells Cosmos.

“Even just making people think that they’re being observed – for example, by putting up a sign with an eye – has the same impact.”

Ostroff says that incivility among surgeons is a well-established problem, citing the Royal Australasian College of Surgeons’ Operating with Respect program as an example of trying to address the matter.

“We know that it can affect patient outcomes in subtle ways, like operating times and complications.

“But it also has a big effect on the attitudes of the healthcare workers themselves – because if you’re in that kind of environment, where people are yelling and disrespectful, it’s stressful, it creates burnout, dissatisfaction, and people leave.”

Attempts to change this culture typically take a lot of time from healthcare workers, for small effects.

“The question was: is there something we can do that won’t take people’s time, that could work?” says Ostroff.

The researchers ran an online survey of staff at a private orthopaedic hospital in Adelaide, asking them about incidents of bad behaviour.

A month later, they put eye signage up around the hospital, and nearly 2 months after that, they ran the survey again.

In the second survey, reports of incivility had dropped significantly. Theatre nurses, in particular, reported less bad behaviour.

The researchers say in their paper that they don’t think the eye signs will work long-term to drop uncivil behaviour. They also point out that the study is limited by being small and survey based (with 74 respondents in the first survey and 45 in the second).

“Is this a permanent solution? I don’t think so,” says Ostroff.

“I think that the next step is do this as part of a bigger awareness [campaign], creating a culture that values people in general, that helps initiatives that help with better communication, which is really at the root of the problem.”

Nevertheless, Ostroff says the research shows that they can change surgeons’ behaviour.

“It was more of a demonstration that even the simplest little things can have an impact.”

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