WHAT ARE SOME POTENTIAL CHALLENGES THAT STUDENTS MIGHT FACE WHEN IMPLEMENTING CAPSTONE PROJECTS IN THE OR

One of the major challenges students may encounter is coordinating their capstone project with surgical schedules and procedures. Operating rooms have very tight schedules to maximize efficiency and see as many patients as possible. Surgical teams are focused on providing care to patients and do not have extra time available. Students would need to work closely with surgeons, administrators, and schedulers to find opportunities to observe procedures and gather needed data or materials for their projects without disrupting clinical care. Additional scheduling challenges could occur if a student’s project requires observing multiple similar procedures over time to track outcomes or collect enough samples for quantitative analysis. Organizing many return trips to the operating room may be difficult to coordinate with surgeons’ schedules.

Related to scheduling challenges is the issue of surgical delays. Any delays or unexpected extensions to a surgical case could impact a student’s ability to complete what they need to for their capstone project during that planned procedure. Operating rooms need to keep to schedule to avoid downstream delays and maintain throughput of patients. Students would have to understand that their projects cannot be allowed to cause delays, even minor ones, and may need alternate plans depending on how cases proceed. Having redundancy planned or an understanding that scheduling multiple observation opportunities may be needed is important. Communication with teams about expectations around delays is important to address this challenge.

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Another key challenge involves ensuring projects do not compromise sterility or disrupt the flow of the surgical environment. Operating rooms have strict protocols around maintaining sterility and established workflows that everyone in the OR must follow. A student’s project data collection, equipment needs, or activities could potentially breach sterility or disrupt the work if not carefully planned. Students may find it difficult to gather some types of data or materials without impacting the sterile field. Capstone projects would need to be designed carefully with input from clinical experts to identify what can be reasonably collected or implemented given sterility and workflow constraints. Students would also need education on OR sterile technique and policies to conduct themselves appropriately.

A further complication could arise from the need to obtain informed consent from surgical patients or providers to be involved in students’ research projects. Patients rightly expect their care to be handled by licensed clinical experts, not trainees. Ensuring patient safety and comfort, obtaining valid consent, and avoiding any perception that projects might influence medical decision making are important complex challenges. Capacity constraints may also impact how many patients can reasonably be recruited within a student’s timeline. Navigating ethical approval processes and addressing concerns about added workload or liability for clinical teams could prove difficult. Strong faculty oversight may be needed to address human subjects challenges.

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Medical equipment availability could pose another hurdle. Operating rooms are equipped for surgery, not necessarily student projects. If projects require specialized equipment, instrumentation, or technologies beyond standard OR setups, obtaining access and ensuring proper training for use may be an obstacle. Equipment may need to be procured, sterilized, and stored appropriately which takes extra resources. Storage space is also limited, and equipment cannot interfere with the sterile field. Finding ways to incorporate student project needs within existing OR constraints and resources requires creative planning.

Students themselves may have steep learning curves when it comes to the clinical environment, timescale expectations, and navigating healthcare systems. Students are not familiar with the realities of fast-paced clinical practice and may underestimate the level of coordination and collaboration required with busy surgical teams. Academic timelines may not align well with realities of project recruitment, data collection periods, or dissemination expectations in healthcare. Learning hospital procedures like OR access, patient privacy and consent rules, IRB processes, and interacting with staff, administrators and providers takes time and support. Ensuring realistic scope, strong guidance, feedback and troubleshooting help for students is important to address challenges of the healthcare climate they are less familiar with.

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There are meaningful logistical, ethical, and systems-based challenges students may encounter when taking capstone work into the operating room. With meticulous planning, oversight, clear contingencies, additional guidance as needed and flexibility on all sides, many of these barriers can be navigated. Early coordination and understanding of OR constraints is key. With the right preparation and support structure, surgical environments could provide rich opportunities for valuable translational student work despite inherent complexities.

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