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Background Within Operating Rooms (OR), teams consisting of professionals with different training and backgrounds are expected to function optimally in a high-risk environment that is scattered with stressors, that often appear simultaneously and are usually related to the ever-present time pressure which is often paired with ineffective teamwork and an ever-increasing workload and stress. This study aimed to investigate whether there are significant differences in teamwork; workload; and stress levels between surgeons, anesthesiologists, and scrub nurses. Methods This was an observational cross-sectional study, conducted over 3 months in 2018, in Sahloul University Hospital; in 4 ORs with different specialties. We used a validated observation sheet to asses teamwork (Observational teamwork assessment for surgery tool) during the intraoperative phase. At the end of each operation, stress and workload of the surgical team members were measured. All ethical considerations were taken into account. Results Overall, 160 participants from the concerned ORs participated in the study and 50 operations were observed. Most of the participants were nurses (45.6%). Concerning teamwork, in fact, surgeons received significantly higher scores on all of the dimensions. The mean global teamwork score for surgeons was 4.87 (SD = 0.75, p &amp;lt; 0.01) on a scale of 0 to 6. Moreover, ANOVA test showed that surgeons experienced higher workload with a mean of 66.88 (SD = 25.98, p &amp;lt; 0.01). However, nurses were significantly more stressed than both anesthesiologists and surgeons. Conclusions This study offered a practical method to evaluate, simultaneously, teamwork, workload and stress in the OR and revealed differences across team members as surgery unfolds. Given the importance of care delivery in the ORs, the findings of this study can be used to lead targeted interventions to enhance the surgical team performance. Key messages There were significant differences between surgical team members in terms of teamwork, workload and stress. Surgeons had higher teamwork and workload; however, nurses had the highest stress.

Differences between surgical team members in terms of teamwork, workload and stress