Human Factors in Healthcare · Published 2026-05-06 · DOI 10.1016/j.hfh.2026.100140
Disruptive behavior in the operating room (OR) poses risks to team performance and patient safety. Paradoxically, traits that are often associated with surgical excellence, like confidence, decisiveness, and strong professional identity, may, within high pressure and hierarchical environments, also manifest destructive behaviors that undermine performance and teamwork. In this viewpoint, we examine the paradox of surgical excellence through a human factors lens, proposing that interactions between leadership culture, authority dynamics, and systems pressures may influence disruptive behaviors. We explore the impact of disruptive behaviors on OR dynamics and highlight opportunities for systems-level strategies to mitigate these risks, including fostering psychological safety, enhancing team resilience, and designing organizational structures that support leadership behaviors. This viewpoint aims to stimulate dialog and future empirical investigation while encouraging healthcare system designs that support surgical mastery and high-performing teams.
Abstract from DOAJ. Public domain (CC0 1.0).
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