Hans Arora, MD, PhD, on improving communication in the OR

In this video, Hans Arora, MD, PhD, discusses the importance of teamwork in surgery, emphasizing communication, simulation, and shared responsibility for patient outcomes. Arora is the chief of the division of pediatric urology, director of pediatric robotic surgery, and associate professor of urology at the University of North Carolina, Chapel Hill.

Arora recapped a session from the 2026 American Urological Association Annual Meeting on surgery as a team sport, emphasizing the need to view surgery as a collaborative effort rather than one centered solely on the individual surgeon. He noted that outcomes depend on the coordinated efforts of surgeons, anesthesiologists, nurses, surgical technicians, residents, and families, particularly when complications or unexpected challenges arise.

“No good outcome is attributable to one single individual,” Arora said, emphasizing the importance of keeping the entire team focused on the patient.

Arora identified ego and the traditional emphasis on individual achievement as major barriers to effective teamwork in the operating room. He argued that modern surgical leadership requires physicians to move beyond a competitive model and develop the skills needed to lead while also serving the team. In his view, effective leadership includes creating an environment in which team members can communicate openly and contribute to managing challenging situations.

To strengthen team performance, Arora emphasized simulation training, particularly for situations in which unexpected problems can disrupt a procedure. He also described the value of beginning the operating room day with a team discussion to review the schedule, patient-specific considerations, equipment needs, and potential disruptions. Although teams often debrief individual cases, he suggested that institutions could benefit from broader end-of-day discussions focused on communication, workflow, and opportunities for improvement. Arora added that surgeons should lead these conversations by asking what they could have done differently to better support the team.