Hearing loss affects 23% of U.S. working-age adults. Only 3.1% of healthcare workers report disabilities, with hearing loss prevalence undefined. The OR presents unique challenges for D/deaf staff and trainees. This study aims to define hearing loss prevalence among OR staff and trainees and identify communication barriers.
A survey on hearing and communication difficulties was developed for OR staff and trainees, assessing experience, age, and hearing difficulties. Results were analyzed using Fischer’s exact test and logistic regression.
A total of 81 OR staff, 51 attendings, 27 residents, and 62 medical students responded (16.2%, 225/1388 response rate). Among them, 11% (24/225) reported baseline hearing loss, with 61% (15/24) under age 50 and 16.7% (4/24) using hearing aids. Excluding those with baseline hearing loss, 57.2% (115/201) reported hearing difficulties. Most respondents (87%, 195/225) agreed that OR communication could be improved. We found no significant association between baseline hearing loss and age (odds ratio: 0.83, p = 1.0) or desire for communication improvement (OR: 4.0, p = 0.18). Logistic regression showed that age group and hearing aid use significantly affect the likelihood of reporting difficulty hearing in the OR. Comments from respondents were collated thematically (Figure).
Hearing difficulties are prevalent among those with and without baseline hearing loss, creating significant communication challenges in the OR. Addressing these challenges requires targeted support and comprehensive strategies to enhance communication in the OR, such as time-out checklists and medical device innovation.
| Theme | Representative Comments |
|---|---|
| Background Noise | "The OR is so noisy with all the equipment and background chatter. Sometimes it's impossible to hear what the surgeon is saying." "The music and side conversations make it very hard to concentrate, especially during critical moments." |
| Speech Clarity | "Masks muffle voices, and it's hard to understand what people are saying. It's even worse with accents or soft-spoken team members." "People need to speak up and clearly. It's frustrating when you have to ask them to repeat multiple times." |
| Hearing Aids | "I use hearing aids, but the noise levels and unclear speech still make it a struggle to follow conversations in the OR." "Even with hearing aids, I have to constantly ask people to repeat themselves or speak louder. It’s very frustrating." |
| Communication Practices | "Closed-loop communication is not practiced enough. It would really help if people repeated back instructions to ensure they were heard correctly." "There's a lack of awareness about the importance of clear communication. People often mumble or talk while facing away, making it hard to hear." |
| Discomfort Speaking Up | "As a medical student, I felt uncomfortable asking people to repeat themselves. I was worried it would reflect poorly on me." "I often just nodded along because I didn't want to interrupt or seem like I wasn't paying attention." "It's intimidating to ask the surgeon to speak louder, especially when they seem annoyed by it." |
| Awareness and Training | "There needs to be more awareness about hearing loss and its impact. People often forget and mumble or speak softly." "Training on communicating effectively in the OR should be mandatory. It's a common issue that definitely affects patient care and it's often ignored." |
Figure: Utilizing thematic analysis, comments from the survey were categorized based on recurring themes. Key themes identified include background noise, unclear speech due to masks, the need for hearing aids, trainee experiences, and the importance of improved communication practices and awareness. Representative comments were selected to illustrate each theme, highlighting the prevalent and unaddressed issues related to hearing loss and communication challenges in the operating room.
Bureau of Labor Statistics. (2024). Persons with a disability: Labor force characteristics—2023 (Report No. USDL-24-1234). U.S. Department of Labor. https://www.bls.gov/news.release/pdf/disabl.pdf
National Institute on Deafness and Other Communication Disorders. (n.d.). Quick statistics about hearing. U.S. Department of Health and Human Services. https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing