Emerging Competency Expectations in Operating Room Nursing: A Qualitative Study of Surgeons’ and Nurses’ Perspectives

Background: The operating room is a high-risk clinical environment in which, beyond technical skills, non-technical competencies, such as communication and collaboration, situational awareness, initiative and advocacy, accountability, cognitive agility, professional autonomy and identity, and emotional resilience, are increasingly critical for ensuring patient safety and maintaining workflow continuity.

Aim: This study aimed to identify emerging competency expectations for operating room nursing (ORN) from the perspectives of surgeons and operating room nurses.

Methods: This qualitative descriptive study was conducted in Türkiye between December 1, 2024 and May 31, 2025. A total of 27 surgeons and 30 operating room nurses from six hospitals in the city centers of two provinces participated in the study. Data were collected through semi-structured, in-depth interviews and analyzed using content analysis.
Results: Five themes emerged: operational flow and efficiency; professional development and standards; professional autonomy and identity; cognitive and mental skills; and emotional and motivational characteristics. Participants emphasized that non-technical competencies, including communication and collaboration, situational awareness, initiative and advocacy, accountability, and the ability to minimize errors under stress, are increasingly essential for ensuring patient safety and maintaining workflow continuity.

Conclusion: Compared with existing operating room (OR) nursing competency frameworks, the findings highlight cross-cutting competencies, including autonomy, professional identity, cognitive flexibility, and emotional resilience, that support technical performance, effective teamwork, and patient safety. Although the findings are not broadly generalizable, they have important implications for competency-based education, competency assessment, mentoring, and initiatives to strengthen patient safety culture.

Keywords: Competence, non-technical skills, operating room nursing, qualitative research, technical skills