Table 4 Perspectives around benefits and/or concerns with ORBBSIM

Benefit(s) of ORBB integration into simulation

 Quality improvement

18

3

13

2

0

“Improved communications. Close call identification of good practice and habits for exhibition.”

 Objective scenarios

13

2

10

1

0

“Gives real scenarios to increase the fidelity of the simulation.”

 Education

9

0

7

2

0

“Provides learning opportunities to see examples of both correct and incorrect behaviors and provide meaningful debriefing sessions after simulations.”

 Metacognition

5

1

4

0

0

 Metrics

4

0

4

0

0

 Real-time data

4

0

3

1

0

 Teamwork

4

1

2

1

0

 Debriefing

3

0

3

0

0

 Increased fidelity

3

0

3

0

0

 Patient safety

3

0

3

0

0

 Buy in

2

0

2

0

0

 Communication

2

0

1

1

0

 Evaluation

2

0

1

1

0

 Psychologically safety

2

1

1

0

0

 Crisis resource management

1

0

1

0

0

 Controlled environment

1

1

0

0

0

 Hawthorne effect

1

0

1

0

0

 Low-frequency, high-acuity events

1

0

1

0

0

 Research

1

1

0

0

0

 Unclear Value Added

1

0

1

0

0

Concern(s) of ORBB integration into simulation

 Psychological safety

7

2

5

0

0

“Potential violation of a safe space of learning if learners are not aware of the black box recordings taking place.”

 Resources

6

3

2

1

0

“Limited resources to properly simulate the complex environment in the OR.”

 Timing

6

3

2

1

0

“My concern would be that it may be hard to find time for the surgical team to participate in simulation activities.”

 Privacy

5

1

4

0

0

 Fidelity

2

0

2

0

0

 Legal

2

0

2

0

0

 Location

2

0

1

1

0

 Cost

1

0

1

0

0

 Culture

1

1

0

0

0

 Data security

1

0

1

0

0

 Hawthorne effect

1

0

1

0

0

 Lack of inclusivity

1

0

1

0

0

 Lack of understanding

1

0

1

0

0

 Mistrust

1

1

0

0

0

 Schedule coordination

1

1

0

0

0